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Corneal Disorders
Published in Ching-Yu Cheng, Tien Yin Wong, Ophthalmic Epidemiology, 2022
Darren S. J. Ting, Rashmi Deshmukh, Daniel S. W. Ting, Marcus Ang
CL wear and ocular trauma have been reported to be the two commonest risk factors for IK in many studies.44–47 Other risk factors for IK include ocular surface diseases, exposure keratopathy, neurotrophic keratitis, chronic dacryocystitis, and iatrogenic causes such as post-corneal surgeries.47–49 Since trauma is one of the most common risk factors for corneal ulcers, studies have been undertaken to examine the benefit of prophylactic antibiotic treatment to prevent IK following corneal trauma. The Bhaktapur Eye Study demonstrated that chloramphenicol 1% ointment started within 18 hours of injury prevented the development of IK following corneal abrasions.49 The benefit of prophylactic topical antibiotic for preventing IK was similarly demonstrated by another study in India.50
Ocular surface as mucosal immune site
Published in Phillip D. Smith, Richard S. Blumberg, Thomas T. MacDonald, Principles of Mucosal Immunology, 2020
Rachel R. Caspi, Anthony St. Leger
Corneal HSV infections are thought to be a leading cause for the development of neurotrophic keratitis (NTK), which is a degenerative disease that leads to the loss of corneal epithelial cells, tear production, and sensation. In addition, this effect is also thought to reduce the amount of immune suppressive molecules released by nerves, which increases the propensity of immune cell priming and subsequent autoimmunity. Recently, in a mouse model, neutralization of IL-6 or the excision of sympathetic nerves promoted the survival of sensory nerves after infection, which substantially reduced the prevalence of HSK.
Mycotic Keratitis Caused by Dematiaceous Fungi
Published in Mahendra Rai, Marcelo Luís Occhiutto, Mycotic Keratitis, 2019
Javier Araiza, Andrés Tirado-Sánchez, Alexandro Bonifaz
Other related factors are evidence of previous non-fungal infections (bacterial or herpes simplex virus), allergic conjunctivitis and neurotrophic keratitis (Thomas 2003, Minervini et al. 2018) and there are reported cases where there is no evidence of previous trauma (Chaidaroon et al. 2015).
Use of Nicergoline as Adjunctive Treatment of Neurotrophic Keratitis in Routine Clinical Practice: A Case Series
Published in Ocular Immunology and Inflammation, 2022
L. Miguel-Escuder, C. Rocha-de-Lossada, N. Sabater-Cruz, José-María Sánchez-González, F. Spencer, S. Marín-Martínez, S. Batlle-Ferrando, X. Carreras Castañer, J. Torras, J. Peraza-Nieves
The cornea is the most densely innervated tissue in the body. Corneal innervation plays an important role in the maintenance and proliferation of the corneal epithelium, and therefore, in wound healing.1 A partial or total loss of corneal sensitivity leads to the development of neurotrophic keratitis (NK).1 NK is a rare degenerative entity which prevalence has been estimated at approximately 1.6–4.2/10,000.2 However, recently has been suggested that NK may be more frequent than previously reported.2 A wide range of ocular or systemic conditions can cause NK, including chronic use of topical drugs (such as glaucoma medications, anaesthetics and/or nonsteroidal anti-inflammatory drugs), ocular surgery, severe dry eye disease, diabetes, neurosurgical procedures, and the most frequent condition, herpetic keratitis. All of them are characterized by corneal hypoesthesia or anaesthesia.3
Neurotrophic Keratopathy in Pediatric Patients
Published in Seminars in Ophthalmology, 2021
A recent retrospective epidemiologic study by Saad et al. reviewed all cases of neurotrophic keratitis presenting to their eye hospital from 2009 to 2017 which included 354 eyes of 335 patients. The majority of these patients were adults, with average age listed as 63.1 ± 21.0 (range 6–101) years. The most common etiology of neurotrophic keratitis was herpetic eye disease, followed by iatrogenic causes (e.g. eye drop toxicity, ocular surgery, complications of radiation) and central nervous system disease (e.g. intracerebral tumors, infection neurofibromatosis, tuberous sclerosis) – all of which may be observed in children.12 One iatrogenic cause not mentioned by the authors is transscleral diode laser cyclophotocoagulation which has been documented in the literature by Fernandez-Vega Gonzalez et al.13 Bonini et al. also cite viral infection as the most common cause of neurotrophic keratopathy, followed by iatrogenic causes such as chemical burns and surgery and intracranial lesions that cause compression of the trigeminal nerve.14
Degeneration of Corneal Sensation and Innervation in Patients with Facial Paralysis: A Cross-Sectional Study Using in Vivo Confocal Microscopy
Published in Current Eye Research, 2019
Jiaying Zhang, Zhanlin Zhao, Chunyi Shao, Yao Fu, Xia Ding, Yuan Cao, Xiaowei Zhu, Xusheng Wu, Wei Wang, Xianqun Fan, Jin Li
Patients with corneal anesthesia were accompanied with more severe corneal lesions. Corneal innervation was diminished strikingly when comparing to the controls (Figure 2f). In other words, neurosurgeries, which may injure the trigeminal nerve and consequently induce corneal anesthesia, have put patients at high risks of developing exposure and neurotrophic keratopathy. The more severe the corneal sensory impairment is, the higher the rapidity of corneal erosion, or even perforation and sight loss. These findings echo a previous case series which reported similar corneal changes in eight patients with neurosurgically induced neurotrophic keratitis.25 The mouse model of neurotrophic keratitis after trigeminal nerve axotomy also demonstrates that corneal nerve damage is evident.26