Purpose

To report the adjunctive use of topical tacrolimus with skin sparing surgery in improving periocular skin quality and restoring eyelid function in cicatricial ectropion secondary to chronic dermatitis from topical anti-glaucoma therapy.

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Methods

An 88 year old male with advanced bilateral normal tension glaucoma, managed with long term topical therapy (Bimatoprost 0.03%, Dorzolamide 2%, Iopidine 1%, Ciclosporin 0.1%), developed right lower lid cicatricial ectropion from chronic periocular dermatitis. Initial surgical repair using a lateral tarsal strip and medial spindle achieved only partial correction. Subsequent management included a two-month course of topical Tacrolimus 0.1% ointment twice daily, regular moisturisation, and guided upward lid massage.

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Results

After two months, periocular skin quality improved markedly. The right lower lid returned to an appropriate anatomical position, with resolution of ectropion, punctal eversion, and associated ocular surface symptoms. Functional improvement was maintained without the need of skin graft.

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Conclusion

Chronic glaucoma therapy can induce periocular cicatricial changes through chronic dermatitis, complicating eyelid function and surgical outcomes. Topical tacrolimus, alongside moisturisation and lid massage, can enhance skin quality and support anatomical and functional restoration of cicatricial ectropion precluding the need of more complex skin graft surgery.

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Additional Authors

First name	Last name	Base Hospital / Institution
Scott	Somerville	The Rotherham NHS Foundation Trust

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