Neurotrophic Keratopathy occurs in some cases during which the trigeminal paralysed, typically as a results of radical treatment for trigeminal Neuralgia.
It doesn't occur altogether cases of peripheral lesions of the trigeminal nerve; thus, if the Gasserian ganglion is removed or the trigeminal injected with alcohol for trigeminal Neuralgia.
with proper precautions, only a couple of cases develop neurotrophic keratitis, the tendency being decreased if there's an adequate tear film.
Clinical features:
The characteristic feature of neurotrophic keratopathy is that the desquamation of the corneal epithelium.
The surface of the cornea becomes dull and therefore the epithelium is thrown off, first at the center then over the whole surface except a narrow rim at the periphery; the entire epithelium may thus peel off intact.
The substantia propria then becomes cloudy and eventually yellow, breaking down into an out sized ulcer which is typically amid a hypopyon.
There is no pain, due to the anaesthesia, but ciliary injection is marked.
Relapses are the rule, the healed scar quickly breaking down again and therefore the whole process being repeated.
Treatment:
the standard treatment of a corneal ulcer should be tried initially, special care being dedicated to the protection of the attention with a shield. Improvement is usually marked, but in some cases, as soon because the shield is relinquished the ulceration starts anew.
Closure of the lacrimal puncta to conserve moisture by abolishing the drainage of tears is usually of great value. If, however, relapses occur, it's best to suture the lids together for up to a minimum of 1 year.
within the operation of lateral tarsorrhaphy after removal or blockage of the Gasserian ganglion, no anaesthetic is important since sensation is lost within the conjunctiva and lids.
The beneficial effect of this procedure is extremely striking, because it invariably succeeds in arresting the method .
