Successful Transition From Topical Ophthalmic Drops to Cream Formulation in the Management of Mild Allergic Conjunctivitis: A Case Report

This case report highlights the successful transition from epinastine eye drops to a novel epinastine eyelid cream in managing mild allergic conjunctivitis. A 33-year-old Japanese female with mild allergic conjunctivitis, previously managed with 0.1% epinastine hydrochloride eye drops, requested an alternative formulation due to daily contact lens wear. Treatment was changed to a once-daily application of 0.5% epinastine hydrochloride eyelid cream. Clinical assessment and symptom evaluation were performed at baseline and after 28 days using slit-lamp examination and the Japanese Allergic Conjunctival Disease Quality of Life Questionnaire. Following the transition, the patient's clinical signs (mild conjunctival hyperemia and moderate papillae) and subjective symptoms (itching and mild discomfort) remained stable. Slit-lamp examination showed no corneal or limbal pathology, and tear fluid immunoglobulin E (IgE) testing remained positive, consistent with mild allergic conjunctivitis. No adverse effects or cutaneous reactions were observed. This case suggests that epinastine eyelid cream may serve as an effective once-daily alternative to conventional eye drops in mild allergic conjunctivitis. While this represents the first documented successful transition between delivery methods, larger clinical trials are warranted to confirm these findings and explore applications across various presentations and severities of allergic ocular disease.