{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T13:23:18Z","timestamp":1787318598181,"version":"build-2736575974"},"reference-count":10,"publisher":"BMJ","issue":"8","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2026,8,2]]},"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:p>A man in his 20s with a background of severe atopic eczema presented with a 24-hour history of intense pain, redness and blurred vision in his left eye. The day before symptom onset, the patient recalls applying Epimax to above the left eyelid. Examination of the left eye revealed findings consistent with a presentation suggestive of chemical injury, demonstrating a total corneal epithelial defect with associated stromal haze. The patient initially declined topical corticosteroid therapy due to prior complications with steroid-induced dermatitis that had necessitated prolonged hospitalisation. After treatment with intensive lubricant, antibiotic and dexamethasone drops, the patient made a good clinical recovery over 1 week. A modified, time-limited course of steroid drops was prescribed and the patient experienced no recurrence of steroid dermatitis. Healthcare professionals should counsel patients on the risks of periocular application of Epimax and maintain awareness of its potential to cause ocular surface toxicity.<\/jats:p>","DOI":"10.1136\/bcr-2026-272266","type":"journal-article","created":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T11:50:15Z","timestamp":1787313015000},"page":"e272266","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Epimax-related ocular surface toxicity on a background of topical steroid withdrawal syndrome"],"prefix":"10.1136","volume":"19","author":[{"given":"Stephen","family":"Morgan","sequence":"first","affiliation":[{"name":"Sussex Eye Hospital, University Hospitals Sussex NHS Foundation Trust, Brighton, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ritika","family":"Mukhija","sequence":"additional","affiliation":[{"name":"Sussex Eye Hospital, University Hospitals Sussex NHS Foundation Trust, Brighton, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0667-3700","authenticated-orcid":false,"given":"Mayank A","family":"Nanavaty","sequence":"additional","affiliation":[{"name":"Sussex Eye Hospital, University Hospitals Sussex NHS Foundation Trust, Brighton, UK"},{"name":"Brighton and Sussex Medical School, Brighton, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,8,21]]},"reference":[{"key":"2026082105201477000_19.8.e272266.1","doi-asserted-by":"crossref","first-page":"131","DOI":"10.1016\/j.clindermatol.2013.05.035","article-title":"Periorbital (eyelid) dermatides","volume":"32","author":"Wolf","year":"2014","journal-title":"Clin Dermatol"},{"key":"2026082105201477000_19.8.e272266.2","doi-asserted-by":"publisher","DOI":"10.3109\/10915818809023137"},{"key":"2026082105201477000_19.8.e272266.3","doi-asserted-by":"crossref","first-page":"3869","DOI":"10.1038\/s41433-023-02620-x","article-title":"Epimax-Related Ocular Surface Toxicity (EROST): the Glasgow experience","volume":"37","author":"Mulholland","year":"2023","journal-title":"Eye (Lond)"},{"key":"2026082105201477000_19.8.e272266.4","doi-asserted-by":"crossref","first-page":"780","DOI":"10.1111\/bjd.21770","article-title":"Topical steroid withdrawal syndrome: time to bridge the gap","volume":"187","author":"Cotter","year":"2022","journal-title":"Br J Dermatol"},{"key":"2026082105201477000_19.8.e272266.5","doi-asserted-by":"publisher","DOI":"10.1016\/S0039-6257(96)00007-0"},{"key":"2026082105201477000_19.8.e272266.6","doi-asserted-by":"crossref","first-page":"1476","DOI":"10.4103\/ijo.IJO_365_18","article-title":"Ocular chemical burns from accidental exposure to topical dermatological medicinal agent","volume":"66","author":"Jinagal","year":"2018","journal-title":"Indian J Ophthalmol"},{"key":"2026082105201477000_19.8.e272266.7","doi-asserted-by":"crossref","first-page":"108696","DOI":"10.1016\/j.exer.2021.108696","article-title":"Low-dose repeated exposure to chemical surfactant impairs corneal epithelium: When personal cleaning products entering the eye","volume":"210","author":"Wu","year":"2021","journal-title":"Exp Eye Res"},{"key":"2026082105201477000_19.8.e272266.8","article-title":"P-9 Epimax-related ocular surface toxicity (EROST): the Glasgow experience","volume":"8","author":"Lockington","year":"2023","journal-title":"BMJ Ophthalmology"},{"key":"2026082105201477000_19.8.e272266.9","doi-asserted-by":"crossref","first-page":"2687","DOI":"10.2147\/OPTH.S235873","article-title":"Management Strategies of Ocular Chemical Burns: Current Perspectives","volume":"14","author":"Soleimani","year":"2020","journal-title":"Clin Ophthalmol"},{"key":"2026082105201477000_19.8.e272266.10","unstructured":"Medicines and Healthcare products Regulatory Agency . Epimax ointment and Epimax Paraffin-Free Ointment: reports of ocular surface toxicity and ocular chemical injury, 17. Drug Safety Update, 2024. Available: https:\/\/www.gov.uk\/drug-safety-update\/epimax-ointment-and-epimax-paraffin-free-ointment-reports-of-ocular-surface-toxicity-and-ocular-chemical-injury"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2026-272266","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T12:24:34Z","timestamp":1787315074000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2026-272266"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8]]},"references-count":10,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2026,8,21]]},"published-print":{"date-parts":[[2026,8]]}},"alternative-id":["10.1136\/bcr-2026-272266"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2026-272266","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8]]}}}