Topical Innovation: A Report on Epinastine Eyelid Cream for Patients With Mild Atopic Keratoconjunctivitis

Allergic conjunctivitis is a common ocular disorder that significantly impacts patients' quality of life. Conventional treatments, primarily anti-allergic and corticosteroid eye drops, require frequent administration, posing adherence challenges. Poor compliance is a major barrier to effective management, particularly in pediatric and elderly patients. Recently, a novel 0.5% epinastine topical eyelid cream, designed for once-daily application, has been introduced as an alternative treatment. However, no clinical reports for atopic keratoconjunctivitis have assessed its efficacy and safety in real-world practice. This study presents a clinical report on the use of 0.5% epinastine topical eyelid cream in three patients with allergic conjunctivitis and atopic dermatitis, evaluating its therapeutic efficacy, adherence, and tolerability. We examined three cases of allergic conjunctivitis associated with atopic dermatitis treated with once-daily 0.5% epinastine topical eyelid cream. Clinical outcomes were assessed using an allergic conjunctivitis severity score based on objective findings. Adherence and safety were also evaluated. All patients exhibited rapid symptom improvement, with significant reductions in ocular pruritus, conjunctival hyperemia, and eyelid dermatitis. By week four, allergic conjunctivitis severity scores had improved markedly in all cases (from baseline scores of 8-13 to 3-6). No adverse effects or treatment discontinuations were observed. Notably, all patients reported high adherence and ease of use, with reduced reliance on eye drops. This case series provides the clinical evidence supporting the efficacy and tolerability of 0.5% epinastine topical eyelid cream for allergic conjunctivitis, particularly in patients with coexisting atopic dermatitis. The once-daily application may enhance adherence and serve as a viable alternative or adjunct to conventional eye drops. Further large-scale studies are warranted to validate these findings.