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. Reproduction in whole or in part in any form or medium without express written permission of the Digital Journal of Ophthalmology is prohibited.