{
  "abstract": "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.",
  "authors": [
    {
      "affiliations": [
        "Southampton Eye Unit, University Hospital, Southampton, UK"
      ],
      "name": "Bhagyashree Joshi"
    },
    {
      "affiliations": [
        "Southampton Eye Unit, University Hospital, Southampton, UK"
      ],
      "name": "Chloe Leftley"
    },
    {
      "affiliations": [
        "Southampton Eye Unit, University Hospital, Southampton, UK"
      ],
      "name": "Harinderjeet Sandhu"
    },
    {
      "affiliations": [
        "Southampton Eye Unit, University Hospital, Southampton, UK"
      ],
      "name": "Parwez"
    },
    {
      "affiliations": [
        "Southampton Eye Unit, University Hospital, Southampton, UK"
      ],
      "name": "Farhan Zaidi"
    }
  ],
  "title": "P9 Further characterisation of Epimax-related ocular surface toxicity",
  "uid": "a8cc326b-75a5-539e-9105-e2511a987f08"
}