Abstract ID: 26-160
Tacrolimus Ointment for Severe Allergic Blepharitis After Silicone Tube Intubation: A Case Series
Author: Hye Sun Choi Base Hospital / Institution: Kim’s eye hospital
Presentation Type: ePoster Presentation
Purpose
To evaluate the clinical characteristics and treatment outcomes of severe allergic blepharitis after silicone tube intubation and to assess the effectiveness of topical tacrolimus as a steroid-sparing therapy.
Methods
We conducted a case series of patients who developed eyelid erythema, edema, and pruritus after silicone tube intubation for lacrimal drainage obstruction or stenosis. Clinical findings were consistent with allergic contact dermatitis involving the eyelids. Initial management included lubricants, antihistamines, and topical corticosteroids. In patients with inadequate response or concern regarding prolonged corticosteroid use, topical tacrolimus ointment was initiated. To reduce ocular irritation, tacrolimus ointment was mixed 1:1 with an artificial tear ointment (Duratears) and applied to the eyelids once daily. Clinical response and adverse events were evaluated during follow-up.
Results
A total of 10 patients were included. All patients presented with periocular erythema, edema, and pruritus consistent with allergic blepharitis. Initial treatment with conventional therapy resulted in partial or transient improvement. Following initiation of tacrolimus, most patients demonstrated marked clinical improvement within several days, with significant reduction in eyelid inflammation and symptoms. Near-complete resolution was achieved in the majority of patients without recurrence during follow-up. No significant adverse effects were observed.
Conclusion
Silicone tube intubation may rarely induce delayed hypersensitivity reactions presenting as allergic blepharitis. Although corticosteroids are commonly used, their limitations necessitate alternative therapies, particularly in patients requiring prolonged treatment. In this case series, topical tacrolimus demonstrated rapid and sustained efficacy and may serve as a safe and effective steroid-sparing option for managing silicone-related periocular allergic reactions.