Dr. Namrata Majhi, M16124, Dr. Namrata Kabra, Dr. Harshavardhan V K
PURPOSE:To describe a rare case of neurotrophic keratopathy
METHOD:Case report
RESULTS:A rare case of trigeminal schwannoma in a 15y male presented with gradual diminution of vision,redness,watering & photophobia in left eye since 3m.BCVA was 6/120.Detailed history & ocular examination was carried out.Past history of excisional biopsy confirming trigeminal schwannoma,grd 3 SPKs on slit lamp,absence of corneal reflex,reduced reflex secretion on schirmer led to diagnosis of gradeI neurotrophic keratopathy.Management started with preservative free lubricants.Subsequent visits showed minimal improvement.Improvement noted on short term collagen punctual plug trial.Synthetic extended punctual plugs were inserted.Significant improvement noted.Vision improved to 6/9.
CONCLUSION:Neurotrophic keratitis represents a real diagnostic challenge & therapeutic dilemma.If diagnosed early & managed properly patients can achieve significant improvement & can avoid complications & sequelae.