Ocular chemical burn is one of emergencies in ophthalmology. Chemical burn caused by alkali can cause more damage because it can penetrate the ocular surface very quickly, causing a saponification reaction due to fatty acids in the cell membrane, thereby damaging the corneal and conjunctival epithelial tissues. Medroxyprogesterone acetate (MPA) is a progesterone derivative which properties and structure are similar to steroids and often used as a contraceptive as a hormone replacement at an affordable price. MPA inhibits IL-1β synthesis which induces collagen degradation by corneal fibroblasts and this effect is associated with suppression of expression or activation of matrix metalloproteinases (MMP-1, MMP-2, MMP-3, and MMP-9), as well as tissue inhibitors of metalloproteinases (TIMP-1 and TIMP-2). Previous studies reported that topical or parenteral MPA reduced the incidence of perforation and ulcers in rabbits. MPA has an additional effect as an anti-inflammatory, with fewer complications when compared to steroids. In this review we discuss the molecular effects of MPA as adjuvant therapy in corneal alkali burn.