Neurotrophic keratitis. Pathogenesis, clinical picture, and diagnostics

Neurotrophic keratitis is a degenerative disease of the cornea caused by reduced corneal innervation. Trauma, tumors, inflammatory lesions and surgical procedures can damage the first branch of the trigeminal nerve on its entire course from brainstem, to and within the cornea. Loss or reduction of corneal innervation leads to a reduced, aqueous phase of the tear film and due to reduced supply with neurotransmitters/trophic factors,also to reduced epithelial healing capacity (impaired mitosis and migration) Combined existence of tear film defined impaired epithelial healing capacity an pacify predispose to persistent epithelial defects, corneal ulcers and perforation. Early diagnosis and adequate treatment may prevent this catastrophic chain of events.