There is no consensus on the choice of systemic and ophthalmic treatment for patients who develop
ocular toxicity with
erlotinib in the few cases reported previously. Various ocular complications related to
erlotinib have been reported, with one of the most serious being
corneal perforation. Our patient was at risk of potential
corneal perforation because of severe cicatricial
ectropion and diffuse punctate corneal epitheliopathy. Therefore,
erlotinib treatment was temporarily discontinued with the approval of the oncology department and the patient was closely followed. She was prescribed
steroid eye
ointment, single-use preservative-free
artificial tears, and eye
lubricant gel to protect the ocular surface. On day 4 of treatment, the patient's findings were significantly improved. After 1 week, the cicatricial
ectropion had dramatically improved and the patient's complaints were completely resolved. To our knowledge, there is no case report of a patient with both
ocular toxicity after long-term use that shows dramatic improvement with drug cessation, and severe cicatricial
ectropion affecting the entire lower eyelid. Here, we described a patient who used
erlotinib for 3 years due to
non-small cell lung cancer and developed severe cicatricial
ectropion which improved dramatically within one week of temporarily discontinuing
erlotinib and discussed the possible reasons. Although ocular complications with
erlotinib are usually encountered early in treatment, it should be kept in mind that
erlotinib-related ocular complications may also arise with long-term use.