Figure 1.

Three Patients Treated With Topical Insulin. A 2-year-old girl with proptosis and lagophthalmos from an orbital teratoma presented with a neurotrophic corneal ulcer refractory to lubrication and permanent lateral tarsorrhaphy (A). Insulin eye drops were initiated with resolution of the ulcer after 14 days (B). A 24-year-old woman with neurotrophic keratopathy secondary to herpes zoster keratitis presents with a corneal ulcer refractory to lubrication and use of scleral contact lens (C). Insulin drops were initiated with resolution of the ulcer after 25 days (D). A 47-year-old woman with neurotrophic keratopathy secondary to cranial nerve injury presents with near descemetocele in the central cornea of the left eye (E). Insulin drops were initiated with resolution of the ulcer after 7 days (F).