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Neurotrophic Keratitis: Definition, clinical presentation and diagnosis
Author(s) -
Said D.,
Dua H.
Publication year - 2017
Publication title -
acta ophthalmologica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.534
H-Index - 87
eISSN - 1755-3768
pISSN - 1755-375X
DOI - 10.1111/j.1755-3768.2017.03322
Subject(s) - medicine , photophobia , corneal perforation , corneal ulceration , keratitis , atrophy , ophthalmology , corneal epithelium , perforation , cornea , dermatology , pathology , materials science , metallurgy , punching
Neurotropic Keratitis is a non‐healing or repeated break down of corneal epithelium associated with degenerative changes resulting from impaired corneal innervation. Later complications such as infection scarring and perforation can follow. A reduced or absent corneal sensation is the hallmark of the disease. Patients present with dryness, photophobia and inability to read for prolonged duration hich is worse by computer work or air draft. Signs are divided into 2 parts: Signs related to the disease process such as corneal epithelial irregularity and clouding, reduced tear break up time and superficial punctate keratitis mostly inferior, Later persistent epithelial defect, corneal ulcers with rolled edges and loose epithelium surrounding the edges which can later develop infection, melting, scarring or perforation. Signs related to the underlying cause such as lagophthalmous and reduced blink reflex, signs of previous herpetic keratitis with scarring, vascularization and or patches of iris atrophy. Stromal dystrophy or beaded corneal nerves, advanced diabetic retinopathy or retinal laser marks. Diagnosis includes clinical presentation, duration of non‐healing epithelial defect and measuring corneal sensation with Coche‐Bonnet test.