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P9 Further characterisation of Epimax-related ocular surface toxicity

bmjophth · 2026-04-29 · canonical JSON source

6 visible annotations · policy: published · automated confidence ≥ 75.00%

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Background Epimax® is widely prescribed and available over the counter (OTC), namely for facial eczema, with frequent periocular application. Case series and regulatory alerts in 2023/24 highlighted ocular surface toxicity associated with Epimax exposure. Despite increased awareness, complications associated with periocular application persist and remain poorly characterised.Methods We retrospectively reviewed the notes of patients over a 12-month period (October 2024-October 2025) who presented with ocular surface symptoms following Epimax, or related emollient, exposure.Results Twelve patients were identified (9 female, 3 males; median age 32 years, range 17-85). 66.7% had a history of eczema and 8.3% of allergic dermatitis. Discrete periocular or ocular exposure occurred in 83.3%. Symptom onset was typically rapid, with 66.7% experiencing symptoms within 48 hours. The main presenting symptoms were redness (58.3%), pain/discomfort (58.3%), epiphora (16.7%), and photophobia (8.3%). Slit-lamp examination demonstrated a consistent epithelial toxicity pattern, with 75% exhibiting punctate epithelial erosions. Management generally consisted of emollient cessation with supportive topical therapy: lubricants (66.7%), antibiotics (58.3%), corticosteroids (58.3%), and vitamin C (33.3%). Adjuncts including bandage contact lenses and cycloplegics were used in select cases. Documented resolution occurred in 91.7% (median time 12 days).Conclusions This series further characterises emollient-associated ocular surface toxicity, raising awareness of a potentially under-recognised and avoidable cause of ocular morbidity. It reinforces the need for clinician awareness and appropriate labelling and counselling, especially given OTC availability.