This is a retrospective study of patients with ocular surface disease (OSIDs) treated with IKERVIS in a single centre between 2016 to 2019 with at least six months follow-up. Clinical outcome was defined as successful (resolved or stable disease), active disease or drug intolerance. Four hundred and sixty-three patients were included with a mean age of 51.5 years, 59% female and mean follow-up time was 14.6 months. The common diagnosis was dry eye disease (DED) 69.5%, allergic eye disease (AED) 11.4%, and ocular mucous membrane pemphigoid/ Steven-Johnson syndrome (OMMP/SJS) 8.2%. Successful treatment was achieved in 74.1% of patients, 9.5% required further treatment and 16.4% reported drug intolerance. The efficacy of IKERVIS was best in DED - 82%, OMMP/SJS - 65.8% and post-keratoplasty - 50%. Drug intolerance was found in significant predictive factors which included age <70years, AED and OMMP/SJS groups of patients. AED and post-keratoplasty groups were most likely to require additional treatment compared to the DED group. The authors concluded that IKERVIS is a useful steroid-sparing agent topical treatment in OSIDs but drugs with better improved tolerance are needed in OSID patients.