Using Insulin And Losartan Eye Drops To Enhance The Visual Outcome In A Case Of Resistant Infected Corneal Ulcer: A Case Report

To evaluate the safety and efficacy of topical insulin and losartan eye drops in accelerating the epithelization of resistant infectious corneal ulcers and reducing corneal scarring afterwards for the sake of improving the visual outcome.

Infectious Keratitis can be a very challenging condition. The etiology of resistant cases include irrational use of antimicrobial therapy, topical preservatives toxicity, neurotrophic keratopathy, and systemic diseases such as diabetes mellitus. In such cases, complications such as corneal melting, perforation, and endophthalmitis are more likely to occur. These issues highlight the need for novel modalities of adjunctive therapy to supplement the standard topical antimicrobial treatment. 

This is a case report of an 80-year-old diabetic patient presented with a resistant fungal corneal ulcer for 4 months. His treatment was modified to reduce epithelial toxicity and insulin eye drops were administered. After complete epithelization, losartan eye drops were then added. And the effect of the two eye drops was recorded with photos.

Complete epithelization of the ulcer was achieved in 3 weeks using insulin eye drops along with topical therapy modification. And the patient’s visual acuity improved after 1 month of adding losartan eye drops.

Both insulin and losartan eye drops are both safe treatment modalities for accelerating the epithelization of resistant infectious corneal ulcers and reducing corneal scarring; and their effects can be promising combined with eliminating other causes of ocular surface toxicity.