Journal of Clinical and Experimental Ophthalmology
Open Access
ISSN: 2155-9570
ISSN: 2155-9570
Poonam Lavaju, Shah S, Joshi I and Pant A R
BP Koirala Institute of Health Sciences, Nepal
Posters & Accepted Abstracts: J Clin Exp Ophthalmol
Introduction: Refractory neurotrophic corneal ulcer is a degenerative disease characterized by decreased corneal sensitivity, spontaneous epithelium breakdown, and impairment of corneal healing which are nonresponsive to multitude of medical treatment. Case Description: A 20-year- old-male presented with a history of sudden onset redness and foreign body sensation of both eye since 3 months associated with photophobia and progressive diminution of vision of both the eyes (RE>LE) since 2 months. He also gave history of oral ulcers 3 months back followed by frequent episodes of dry mouth. On examination, the best corrected visual acuity (BCVA) in RE was 1/60 and LE 6/12. Blepharospasm was present in the both eyes (OU). There was presence of posterior blepharitis and thickening of the eyelid margins and keratinization, bilateral conjunctival xerosis and diffuse ciliary congestion OU. RE cornea showed epithelial defect of 4.5x1.5 mm with thinning (~80%) and LE had diffuse SPKs. Corneal sensation was decreased with Schirmer�s test I reading of 1 mm OU. Anterior segment and fundus examinations were within normal limits in both eyes. Provisional diagnosis of refractory neurotrophic corneal ulcer was made and autologous serum eye drops (20%) was started in RE 4 hourly along with topical preservative free tear substitutes and weak steroids in both the eyes. The patient showed dramatic improvement in signs and symptoms within one week of initiation of treatment. Conclusion: Management of refractory neurotrophic corneal ulcer is a challenge for ophthalmologists. Autologous serum eye drops can be useful in such cases and may prevent further complications.
Poonam Lavaju is currently working as an Additional Professor in the Department of Ophthalmology at BP Koirala Institute of Health Sciences, Dharan, Nepal. She is involved in academics program for undergraduate and post graduate students in ophthalmology. She is In-Charge of the Department. She has published articles in index journals both in national and international journals. She is one of the Board Members in Nepal Eye Bank Committee.
Email: drpoonamlavaju@yahoo.com