eMedicine Specialties > Ophthalmology > Cornea

Keratopathy, Neurotrophic: Follow-up

Author: Robert H Graham, MD, Senior Associate Consultant, Department of Ophthalmology, Mayo Clinic, Scottsdale, Arizona
Coauthor(s): Mark A Hendrix, MD, Consulting Staff, Department of Ophthalmology, Suburban Hospital, Shady Grove Hospital
Contributor Information and Disclosures

Updated: Feb 3, 2009

Follow-up

Further Inpatient Care

  • Patients with stage 3 neurotrophic keratopathy should be hospitalized for daily follow-up care until significant improvement is seen.

Further Outpatient Care

  • Patients with stage 1 neurotrophic keratopathy can be monitored on an outpatient basis every 3-7 days.
  • Patients with stage 2 neurotrophic keratopathy should be monitored on an outpatient basis every 1-2 days until improvement is seen, then every 3-5 days until resolution.

Deterrence/Prevention

  • Educate all patients with corneal hypesthesia about their condition.
  • Carefully evaluate patients with herpes simplex or herpes zoster for corneal hypesthesia.
  • Carefully evaluate patients undergoing surgery for trigeminal neuralgia or acoustic neuroma for corneal hypesthesia postoperatively.

Complications

  • Corneal perforation
  • Secondary bacterial keratitis
  • Permanent decrease in acuity from corneal scarring and irregular astigmatism

Prognosis

  • Negative prognostic indicators include degree of sensory loss, duration of condition, and presence of other ocular surface disease.

Patient Education

  • Instruct patients to seek evaluation immediately if the eye becomes red or if the vision changes.
  • Patients need to understand that serious conditions may not cause them any pain.

Miscellaneous

Medicolegal Pitfalls

  • Failure to diagnose and treat aggressively
  • Failure to identify an underlying cause of corneal hypesthesia, such as a tumor or an aneurysm
 


More on Keratopathy, Neurotrophic

Overview: Keratopathy, Neurotrophic
Differential Diagnoses & Workup: Keratopathy, Neurotrophic
Treatment & Medication: Keratopathy, Neurotrophic
Follow-up: Keratopathy, Neurotrophic
References
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References

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Further Reading

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Keywords

neurotrophic keratopathy, neurotrophic keratitis, neuroparalytic keratitis

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Contributor Information and Disclosures

Author

Robert H Graham, MD, Senior Associate Consultant, Department of Ophthalmology, Mayo Clinic, Scottsdale, Arizona
Robert H Graham, MD is a member of the following medical societies: American Academy of Ophthalmology, American Medical Association, and Arizona Ophthalmological Society
Disclosure: WebMD/eMedicine Salary Employment

Coauthor(s)

Mark A Hendrix, MD, Consulting Staff, Department of Ophthalmology, Suburban Hospital, Shady Grove Hospital
Mark A Hendrix, MD is a member of the following medical societies: American Academy of Ophthalmology and American Medical Association
Disclosure: Nothing to disclose.

Medical Editor

Stephen D Plager, MD, FACS, Chief, Department of Ophthalmology, Dominican Hospital; Assistant Clinical Professor, Department of Ophthalmology, Stanford University Hospital
Stephen D Plager, MD, FACS is a member of the following medical societies: American College of Surgeons, American Medical Association, American Society of Cataract and Refractive Surgery, and California Medical Association
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: Nothing to disclose.

Managing Editor

Christopher J Rapuano, MD, Professor, Department of Ophthalmology, Jefferson Medical College of Thomas Jefferson University; Co-Chairman of the Cornea Service, Co-Chairman of Refractive Surgery Department, Wills Eye Institute
Christopher J Rapuano, MD is a member of the following medical societies: American Academy of Ophthalmology, American Society of Cataract and Refractive Surgery, Eye Bank Association of America, Pennsylvania Medical Society, and Philadelphia County Medical Society
Disclosure: Allergan Honoraria Speaking and teaching; Allergan Consulting fee Consulting; Alcon Honoraria Speaking and teaching; Inspire Honoraria Speaking and teaching; RPS Ownership interest Other

CME Editor

Lance L Brown, OD, MD, Ophthalmologist, Affiliated With Freeman Hospital and St John's Hospital, Regional Eye Center, Joplin, Missouri
Disclosure: Nothing to disclose.

Chief Editor

Hampton Roy Sr, MD, Associate Clinical Professor, Department of Ophthalmology, University of Arkansas for Medical Sciences
Hampton Roy Sr, MD is a member of the following medical societies: American Academy of Ophthalmology, American College of Surgeons, and Pan-American Association of Ophthalmology
Disclosure: Nothing to disclose.

 
 
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