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Neuroparalytic keratitis
Last reviewed: 07.07.2025
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Neuroparalytic keratitis develops after the first branch of the trigeminal nerve is cut, sometimes after injections into the Gasserian ganglion or after its extirpation. In some infectious diseases, the conductivity of the first branch of the trigeminal nerve is blocked. Along with the disturbance of tactile sensitivity, there is a change in trophic processes. Corneal disease may not appear immediately, but after some time.
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Symptoms of neuroparalytic keratitis
Symptoms of neuroparalytic keratitis have their own characteristics. The course of the disease is initially asymptomatic and is often detected by chance. There is no sensitivity of the cornea, so there is no characteristic subjective corneal syndrome: photophobia, lacrimation and blepharospasm, sensation of a foreign body, despite the roughness of the corneal surface. All mechanisms of notification of the onset of the pathological process are paralyzed. There is also no pericorneal injection of vessels. At first, changes appear in the central part of the cornea: swelling of the superficial layers, swelling of the epithelium, which gradually peels off, 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 coccal flora joins, a cloudy grayish-white or yellowish infiltration occurs, a purulent ulcer of the cornea 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 dust penetration using semi-hermetic glasses. Prescribed drugs improve corneal trophism and regeneration processes, as well as protect it from infection. Instillations of drugs are combined with the placement of ointments and gels behind the eyelid. They keep the drug on the surface of the cornea longer and at the same time cover the exposed surface, facilitating epithelialization. If indicated, according to the recommendations of a neurologist, physiotherapy procedures are performed to stimulate the function of the sympathetic cervical nodes.
In cases where there is a risk of corneal perforation, surgical eye protection is used - suturing the eyelids, leaving a gap at the inner corner of the eye for instillation of medications.