Erlotinib-related Corneal Melting

We read with interest the article entitled, “Ocular Adverse Events of Systemic Inhibitors of the Epidermal Growth Factor Receptor: Report of 5 Cases” by Saint-Jean et al. The severity of ocular toxicities of epidermal growth factor (EGF) receptor inhibitors is now being more widely recognized, with reports of permanent visual impairment from corneal scarring after persistent epithelial defect to severe corneal melting and even perforation. Whereas Johnson et al and Saint-Jean et al report reversibility of corneal epithelial erosions with lubricants and cessation of the EGF receptor inhibitors, we encountered a more severe case that did not respond to such treatment and was ultimately managed with autologous serum eye drops.