Testing of corneal sensation is essential to confirm the diagnosis. The corneal sensation OS was completely absent in this patient. A history of herpes simplex keratitis or herpes zoster on the same side of the neurotrophic epithelial defect is common. Other associated conditions that need to be considered in the differential diagnosis include topical anesthetic abuse and crack cocaine abuse. Conditions affecting the fifth cranial nerve, such as neurosurgery, cerebellopontine angle tumors, and pontine stroke, can also result in corneal anesthesia and epithelial breakdown.
Epithelial breakdown can lead to non-infectious and infectious corneal ulcers.
In severe cases, corneal perforation may result. Mild cases with some preservation of corneal sensation may be treated with antibiotic ointments, artificial tears, and frequent follow-up. More severe cases require bandage contact lenses with antibiotic coverage. Not uncommonly, a lateral tarsorrhapy may be necessary to prevent epithelial breakdown. All rights reserved.