Neurotrophic Keratitis: MD Winner

Case Information

This a 36-year-old female with no known comorbids. She has a 7-year history of on and off redness of the left eye associated with blurring of vision, which was previously diagnosed as HSV stromal keratitis. However, due to financial constraints, the patient was noncompliant with medications and follow-up consults. This then led to the development of a large geographic ulcer, which gave her unbearable foreign body sensation and photophobia. Her eye was put on bandage contact lens, copious lubrication with preservative-free sodium hyaluronate drops, prophylactic topical antibiotics, and oral Acyclovir at 400mg/tab twice daily. Although significant corneal scarring had already occurred, her subsequent follow ups showed significant improvement in the epithelial healing.

Medical History:

The patient has no known comorbids.

Concomitant Medications:

Ganciclovir gel (noncompliant)

Diagnosis:

Neurotrophic Keratitis secondary to Metaherpetic Keratitis from recurrent HSV OS

Treatment:

Debridement and bandage contact lens w/ preservative-free sodium hyaluronate drops hourly. Levofloxacin 0.5% drops BID, Atropine sulfate once a day at night, and Acyclovir 400mg/tab BID.