Topical Insulin For The Management Of Neurotrophic Corneal Ulcer: A Case Report.

Published 2026 - 44th Congress of the ESCRS

Reference: POCOR491 | Type: Poster | DOI: 10.82333/f15x-jd86

Authors: Ms Zoe Kritikou* ¹ , Ms Anna Kouroupaki ¹ , Ms Sophia Makryllou ¹ , Charoula Lymperopoulou ¹ , Christina Garnavou-Xirou ¹ , Tina Xirou ¹ , Stamatia Kampanarou ¹

¹Ophthalmology,General Hospital of Athens, Korgialenio-Benakeio Hellenic Red Cross,Athens,Greece

Purpose

To report the clinical outcome of a patient with a treatment-resistant neurotrophic corneal ulcer successfully managed with topical insulin drops.

Setting

Department of Ophthalmology, General Hospital of Athens, Korgialenio-Benakeio Hellenic Red Cross, Greece.

Methods

Case report and review of clinical management. A 67-year-old female with a history of recurrent herpetic keratitis presented with a persistent neurotrophic epithelial defect in the right eye (RE). The ulcer had failed to respond to standard treatments, including preservative-free lubricants and therapeutic contact lenses.

Results

Topical insulin drops were prepared by diluting regular insulin in artificial tears to a final concentration of 1 U/mL. The patient administered the drops three times daily. At the 2-week follow-up, significant improvement was observed, with marked reduction of the epithelial defect and progressive re-epithelialization. No local or systemic adverse effects were observed.

Conclusions

Topical insulin may represent a safe, effective, and low-cost therapeutic option for the management of neurotrophic ulcers, including those secondary to herpetic keratitis. Its efficacy appears comparable to more invasive and costly treatments, like amniotic membrane transplantation or autologous serum therapy. Larger studies are required to establish standardized preparation and dosing protocols.

FINANCIAL DISCLOSURE: None