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Case Reports
. 2025 Jul 9;17(7):e87589.
doi: 10.7759/cureus.87589. eCollection 2025 Jul.

Epinastine Eyelid Cream as a Practical Option for Patients With Glaucoma on Multidrug Topical Therapy: A Case Report

Yui Nishijima  1   2 , Daisuke Hasegawa  1   2 , Tatsuya Mimura  1   3
Affiliations
Case Reports

Epinastine Eyelid Cream as a Practical Option for Patients With Glaucoma on Multidrug Topical Therapy: A Case Report

Yui Nishijima et al. Cureus. .

Abstract

Patients with glaucoma often require long-term use of multiple ophthalmic medications, which can make adherence to additional treatments, such as anti-allergic eye drops for seasonal allergic conjunctivitis, particularly challenging. Moreover, corticosteroid eye drops or ointments, commonly used to manage ocular allergy, are generally avoided in these patients due to the risk of increasing intraocular pressure. We report a case in which a patient with glaucoma, already undergoing multiple topical therapies, experienced recurrent allergic conjunctivitis and blepharitis each spring. The use of conventional anti-allergic eye drops had limited efficacy due to poor adherence associated with the complexity of the treatment regimen. To address this, a newly introduced epinastine cream was applied to the eyelids once daily as an alternative treatment. Following this change, the patient's allergic ocular symptoms improved substantially, with enhanced treatment compliance and no adverse effects on intraocular pressure during follow-up. This case suggests that non-ocular-drop formulations, such as eyelid creams, may offer a practical and effective approach for managing allergic eye disease in patients with glaucoma who are already on complex topical regimens.

Keywords: adherence; allergic conjunctivitis; epinastine; eye drops; eyelid cream; glaucoma.

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Conflict of interest statement

Human subjects: Informed consent for treatment and open access publication was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. Latest ocular findings in a 40-year-old man undergoing glaucoma treatment.
(A) Optical coherence tomography (OCT) images of both eyes showing thinning of the retinal nerve fiber layer. (B) Humphrey visual field test results of both eyes demonstrating marked visual field constriction consistent with glaucoma.
Figure 2
Figure 2. Eyelid findings before and after eyelid cream treatment.
(A) Eyelid findings during treatment with epinastine eye drops, showing marked eyelid dermatitis and allergic conjunctivitis. (B) Eyelid findings two weeks after initiating epinastine eyelid cream, showing clear improvement of blepharitis and conjunctivitis symptoms.
See this image and copyright information in PMC

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