Non-Infectious Corneal Disorders: Exposure Keratopathy, Neurotrophic Keratopathy

Question 1

what disorder is caused by incomplete eyelid closure (lagophthalmos) →
facial nerve palsy, eyelid scarring, proptosis, eczematous skin lightening, sedated pts, etc.

Answer 1

exposure keratopathy

Question 2

these signs are indicative of what disorder?

• mild punctate epithelial defects (SPK) involving inferior cornea
• progressive worsening can including epithelial breakdown, stromal melting & corneal perforation

Answer 2

exposure keratopathy

Question 3

these symptoms are indicative of what disorder?

foreign body sensation, pain
photophobia

Answer 3

exposure keratopathy

Question 4

these treatments are for which disorder?

aggressive lubrication, nighttime ointment, eyelid taping, bandage soft CLs, amniotic membrane, tarsorrhaphy (temp./perm suture lateral aspect of lids)

treat underlying conditions (i.e. eyelid weights for CN VII palsy)

Answer 4

exposure keratopathy

Question 5

what disorder is from the loss of trigeminal innervation to cornea

Answer 5

neurotrophic keratopathy

Question 6

these cause what disorder?

• recurrent HSV/HZV infection of cornea (most common)
• trigeminal ganglion ablation for treatment of trigeminal neuralgia
• peripheral neuropathy due to diabetes

Answer 6

neurotrophic keratopathy

Question 7

reduced corneal sensitivity, reduced blinking rate are symptoms for what disorder?

where does it tend to occur?

Answer 7

neurotrophic keratopathy

-tends to occur on inferior third of cornea

Question 8

what are the 3 stages of neurotrophic keratopathy?

Answer 8

stage 1 — interpalpebral epithelial irregularity, staining & edema
stage 2 —persistent epithelial defect
stage 3 — stromal melting/scarring

Question 9

these clinical findings are indicative of?

decreased/absent tear reflex, intracellular edema
loss of goblets, persistent ulceration

Answer 9

neurotrophic keratopathy

Question 10

these treatments are for what disorder?

aggressive lubrication, oral tetracyclines, eyelid taping at night, tarsorrhaphy, botox-induced ptosis, bandage soft CLs, amniotic membrane

Answer 10

neurotrophic keratopathy