Topical Cyclosporine A-Induced Trichomegaly of the Eyelashes

A thirty-one-year-old male patient was admitted to our outpatient clinic complaining of eye redness, foreign body sensation, and eyelash elongation. He also complained of ocular itching and burning. Due to keratoconjunctivitis sicca, he used artificial tears and gels for five years. It was also ascertained that he regularly used topical cyclosporine-A 0.05% (Restasis, Allergan, Inc, Irvine, California) four times a day for two years. His eyelashes became more curly and elongated after using this medication. It was also ascertained that the patient regularly required trimming of his eyelashes. He had hypertrichosis and elongation in the bilateral upper lid lashes (Figure 1). The ocular examination revealed conjunctival hyperemia, corneal punctate staining, and vascularization at the peripheral cornea. He had also filamentary keratitis (Figure 2). The Schirmer test was less than 5 mm bilaterally. Topical CsA therapy was stopped, and artificial tears and fluorometholone/tetrahydrozoline drops were administered. The patient used no systemic drugs, such as epidermal growth factor receptor (EGFR) inhibitors, prostaglandins, tacrolimus, minoxidil, or interferon (IF)-alpha. The patient was informed about the report, and signed consent form was collected. Dear Editor,