Ophthalmic Losartan
Losartan has traditionally been used to treat hypertension and reduce complications associated with heart failure. Emerging research suggests that topical losartan may support the healing of corneal scarring and opacity resulting from trauma, disease, or surgical complications that can lead to vision impairment5. Corneal opacity represents a major global cause of vision loss, affecting millions of people worldwide. The condition is characterized by stromal scarring and fibrosis driven largely by transforming growth factor-β (TGF-β), which results in permanent visual impairment. Although corneal transplantation is the standard definitive therapy, its impact is limited by donor scarcity, high financial burden, and inadequate access to medical facilities.
Compounded losartan ophthalmic drops may provide clinicians with a topical treatment option for patients experiencing corneal scarring.
Role in Therapy
Corneal scarring is a significant contributor to vision impairment. Myofibroblasts play a central role in the scarring process through their production of the cytokine transforming growth factor beta (TGF-β)1. Losartan, an angiotensin II receptor blocker (ARB), has been shown to inhibit TGF-β–mediated signaling pathways. Studies evaluating topical losartan report minimal ocular toxicity and improvement in corneal scarring following treatment.
Did you know?
Typical duration of therapy is 6 months. If no improvement in scarring is noted after 4-5 months of therapy, treatment should be discontinued.
What does the research say?
- A prospective clinical case series investigated whether topical losartan eye drops (1 mg/mL) could reduce established corneal scarring (fibrosis) and improve vision in adults with corneal opacity. The treatment was given six times daily for three months.
Participants
- 19 eyes from 17 adults with established corneal stromal fibrosis from various causes such as:
- Herpetic keratitis
- Bacterial and fungal keratitis
- Hydrops
- Interstitial keratitis
- Chemical burns
- Pterygium surgery scarring
- All had stable fibrosis for ≥1 month and no other eye diseases affecting vision.
Treatment Details
- Topical losartan was prepared at 1 mg/mL by dissolving losartan potassium into sterile balanced salt solution.
- Patients self‑administered 1 drop in the affected eye 6× daily for 3 months.
Key Findings
- Unaided distance visual acuity (UDVA) improved significantly after three months of losartan therapy, indicating enhanced vision clarity.
- Nearly half of treated eyes gained ≥2 lines of Snellen equivalent vision, indicating meaningful functional improvement in many patients.
- Corneal densitometry (an objective measure of opacity) decreased significantly, especially in the midperipheral cornea, showing less scarring and improved transparency.
Tolerability
- No serious adverse effects were observed.
Minor Side Effects
- Mild conjunctival hyperemia (eye redness) in one patient (5.3%), with brief, mild discomfort for the first 2 days.
- No reports of:
- Corneal staining or erosion
- Burning or stinging
- Dryness
- Photophobia
- Foreign body sensation
- No patients discontinued therapy due to side effects.
All ophthalmology prescriptions are shipped overnight with compimentary shipping. Call us a 404-815-1610 for formulation or logistical questions.
Potential Applications
Research has shown that topical losartan should be explored as a potential treatment in the following conditions:
- Lacerations
- Refractive surgery complications (LASIK or SMILE)
- Viral infections, such as herpes simplex keratitis and herpes zoster
- Bacterial, fungal, or acanthamoeba keratitis
- Chemical burns
References
Chaudhury, A., & Howe, P. H. (2009). The tale of transforming growth factor-beta (TGFbeta) signaling: a soigné enigma. UBMB life, 61(10), 929–939. https://doi.org/10.1002/iub.239
Cleveland Clinic. (2024, February 6). How to use topical losartan to potentially treat cornea damage. Consult QD.https://consultqd.clevelandclinic.org/how-to-use-topical-losartan-to-potentially-treat-cornea-damage/
Domene-Hickman JL, Haro-Morlett L, Lichtinger A, Hernandez-Solis A, Ramirez Miranda A, Navas A, Graue-Hernandez EO. Topical losartan for established corneal fibrosis with machine learning-based predictors. Ther Adv Ophthalmol. 2025 Nov 14;17:25158414251378123. doi: 10.1177/25158414251378123. PMID: 41245430; PMCID: PMC12618809.
Stodola, E. (2023, September). Losartan for the cornea, conjunctiva, glaucoma, and beyond. EyeWorld. https://www.eyeworld.org/2023/losartan-for-the-cornea-conjunctiva-glaucoma-and-beyond/
Wilson S. E. (2023). Topical Losartan: Practical Guidance for Clinical Trials in the Prevention and Treatment of Corneal Scarring Fibrosis and Other Eye Diseases and Disorders. Journal of ocular pharmacology and therapeutics : the official .Journal of the Association for Ocular Pharmacology and Therapeutics, 39(3), 191–206 https://doi.org/10.1089/jop.2022.0174.
