Neurotrophic Keratitis!
- Corneal innervation by the trigeminal nerve (5th cranial nerve) is impaired.
- Partial or complete loss of corneal sensation can result in epithelial keratopathy, epithelial defect, stromal ulceration, and eventually corneal perforation.
TREATMENT: (According to stages of Mackie Classification).
Stage 1:
-Withdrawal of epitheliotoxic drugs, preservative-free lubricating drops, BCL, Oral tetracycline/doxycyline.
Stage 2:
-Preservative-free lubricants and ointment, growth factors, Autologous serum eyedrops, Patching, Tarsorrhaphy.
Stage 3:
-Collagenase inhibitors (tetracycline, Vitamin C).
-Cyanoacrylate glue with BCL.
-Conjunctival Gunderson Flap.
-Amniotic Membrane Grafting.
-Penetrating Keratoplasty.
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