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Neuroparalytic keratitis
Last reviewed: 17.10.2021
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Neuroparalytic keratitis develops after crossing the first branch of the trigeminal nerve, sometimes after injections into the region of the Gasser node or after its extirpation. With some infectious diseases, the conductivity of the first branch of the trigeminal nerve is blocked. Together with the violation of tactile sensitivity, the trophic processes change. Disease of the cornea may not appear immediately, but after some time.
[1], [2], [3], [4], [5], [6], [7], [8], [9], [10], [11], [12], [13], [14], [15], [16], [17]
Symptoms of Neuroparalytic Keratitis
Symptoms of neuroparalytic keratitis have features. The course of the disease is initially asymptomatic, and it is often discovered by chance. The sensitivity of the cornea is absent, so there is no characteristic subjective corneal syndrome: photophobia, lacrimation and blepharospasm, foreign body sensations, despite the roughness of the corneal surface. All mechanisms of notification about the onset of the pathological process are paralyzed. There is also no pericorneal injection of vessels. First, there are changes in the central part of the cornea: puffiness of the surface layers, bloating of the epithelium, which gradually disappears, erosions are formed, which quickly merge into an extensive defect. The bottom and edges of such a defect remain clean for a long time. If the cocci flora is attached, a dull grayish-white or yellowish infiltration occurs, a purulent corneal ulcer is formed.
The course of neurotrophic keratitis is sluggish and prolonged.
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Treatment of neuroparalytic keratitis
Treatment of neuroparalytic keratitis is symptomatic. First of all, it is necessary to protect the affected cornea from drying out and getting dust with semi-hermetic glasses. Prescribe drugs that improve the trophism of the cornea and regeneration processes, as well as protect it from the invasion of infection. Instillations of medicines are combined with the laying of ointments and gels for the eyelid. They retain the drug longer on the surface of the cornea and at the same time cover the exposed surface, facilitate epithelization. In the presence of indications, according to the recommendations of a neurologist, physiotherapy is carried out, stimulating the function of sympathetic cervical nodes.
In cases where there is a threat of perforation of the cornea, resort to surgical protection of the eye - eyelid cross-linking, while at the inner corner of the eye leave a gap for instillation of medicines.