Neurotrophic Keratopathy

Neurotrophic Keratopathy
		SYMPTOMS	Possible irritation \| Blurry vision \| Usually asymptomatic
		SIGNS	Epithelial punctate defects \| Injection \| Corneal ulcer with rolled edges \| Corneal thinning
		WORK-UP	Thorough history and slit lamp examination with NaFl stain \| Test corneal sensitivity (i.e. cotton wisp test)
		TREATMENT	Preservative-free artificial tears 1 gtt q1-3h \| Topical vigamox or besivance 1 gtt q1-2h \| Amniotic membrane placement \| Oral vitamin C (1 g qd) \| Oral doxycycline 100 mg bid may be considered \| Corneal transplant may be required \| Oxervate 1 gtt q2h, 6x/day for 8 weeks
		FOLLOW-UP	Daily
		ADDITIONAL LAB \| TESTS	Corneal esthesiometry
		ETIOLOGY	Conditions that reduce corneal sensitivity may cause Neurotrophic Keratopathy, such as: Ocular surgery \| Herpes virus \| Acoustic neuroma \| Topical anesthetic abuse \| Chemical injury
		DIFFERENTIAL DX	SPK \| Limbal stem cell deficiency \| Exposure keratitis
		NOTES	Neurotrophic Keratopathy typically presents with diminished corneal sensation and therefore little to no symptoms