The allergic eye disease spectrum comprises a number of illnesses, each with its own set of complex immunopathologies. Antiallergic medications, such as antihistamines and mast cell stabilisers, are frequently insufficient in the absence of concurrent topical corticosteroid treatment. The chronic nature of the more severe allergic eye illnesses, such as vernal keratoconjunctivitis (VKC) and atopic keratoconjunctivitis (AKC), limits the use of topical corticosteroids to short courses of treatment. Furthermore, topical corticosteroid treatment puts patients at great risk of having severe ocular consequences, especially during youth, when VKC is most common. Chronic disease immunopathology, such as VKC and AKC, involves largely T cells; thus, immunomodulators that suppress T-cell activation appear to be the right treatment for these chronic diseases. In recent years, there has been an upsurge in the use of the immunomodulator tacrolimus to treat chronic allergic eye disorders. The current study provides an update on the most recent clinical experience with topical tacrolimus for the treatment of persistent allergic ocular disorders.

Topical tacrolimus greatly reduces the symptoms and indicators of chronic allergic eye illness. Early medical treatment with topical tacrolimus can also help to prevent the development of significant ocular problems associated with VKC, such as shield ulcers or limbal stem cell deficit. Topical tacrolimus has drastically altered care strategies for severe and chronic allergic ocular disorders, reducing the need for topical corticosteroids.

Reference: https://journals.lww.com/co-allergy/Abstract/2019/10000/Topical_tacrolimus_for_allergic_eye_diseases.19.aspx