Topical tacrolimus is an aqueous suspension sometimes used in corneal healing and tear production.1 In particular, volumes of research show its usefulness in dogs as an alternative to cyclosporine.2 The hope—for humans—is that it can spare patients with any kind of ocular surface inflammation the potential complications of steroids. Now, research is showing that patients with Thygeson superficial punctate keratitis can dodge steroids using tacrolimus 0.02%.3

The researchers looked at the records of 10 patients—three males and seven females—all with Thygeson superficial punctate keratitis. Seven of those patients were previously unresponsive when prescribed topical steroids or lubricants. All ten had bilateral involvement and were treated with topical tacrolimus 0.02% twice daily.3

The investigators looked at how their symptoms improved, including tearing and photophobia, as well as structural signs. Notably, they examined the number, flattening and resolution of lesions and noted any decreases in staining.3

They found that all of the study patients experienced subjective improvement in symptoms such as tearing and photophobia and resolution of the superficial punctate keratitis in 72 hours after initiation of therapy. Tacrolimus was well tolerated in all patients, as well.3

1. Al-Amri A, Fiorentini S, Albarry M, et al. Long-term use of 0.003% tacrolimus suspension for treatment of vernal keratoconjunctivitis. Oman J Ophthalmol. 2017;10(3):145-49.

2. Berdoulay A, English R, Nadelstein B. Effect of topical 0.02% tacrolimus aqueous suspension on tear production in dogs with keratoconjunctivitis sicca. Vet Ophthalmol. 2005;8(4):225-32.

3. Shoughy S, Tabbara K. Topical tacrolimus in thygeson superficial punctate keratitis. Cornea. December 12, 2019. [Epub ahead of print].