Previous studies have determined that topical insulin use was effective in accelerating epithelial defect closure in patients with neurotrophic keratitis. When epithelialization is not achieved in two weeks with stan­dard initial treatment, this option would is an effective first-­line treatment option.  One study found that topical insulin is a safe and effective alternative to treat epithelial defects that don’t improve despite conventional treatment.

96.8% of eyes achieved closure of the epithelial defect with this treatment.

The average closure time was shorter in non-diabetics compared to diabetics. 9.3% experienced burning and 6.25% reported pain. 


Hernandez AJI, Gomez EA, Velasco R, et al. Effectiveness and safety of topical insulin in persistent epithelial defects refractory to treatment. ARVO 2025 annual meeting.