Neurotrophic Keratitis: A Review

Impairment in trigeminal nerve function causes a loss of corneal sensation and can lead to neurotrophic keratitis (NK). This gradual deterioration in the surface integrity of the cornea predisposes to the development of ulcers and may even progress to perforation, posing a risk for profound vision loss. Many common ophthalmic and systemic conditions, such as herpetic infections, ocular surgeries, neurosurgical procedures, multiple sclerosis and diabetes, can elicit NK by injuring the trigeminal nerve. Disease progression can occur rapidly and without symptoms, therefore, detecting NK early is critical. Management aims to halt continuing corneal damage and promote epithelial cell healing and nerve fibre regeneration. Novel treatment options show promise in restoring corneal sensitivity by re-establishing innervation, targeting the fundamental source of NK.