Neurotrophic Keratitis: OD Winner

Case Information

A highly myopic 50-year-old Caucasian male presents to my clinic after retinal detachment surgery OS with a complaint of poor vision (20/400 OS). An examination reveals 3+ neurotropic keratitis with reduced corneal sensitivity OS, 3+ nuclear sclerosis OS, and macular scar OS. The patient desires a second opinion from a retinal surgeon but needs a clear ocular surface and phacoemulsification prior to surgery.

Medical History:

OS PVD, RD repaired with gas bubble -2023 by retinal surgeon; Nuclear Cataract OU; Dry eye OU previously treated with autologous serum 2023; +hypercholesterolemia, +hypertension, +GERD

Concomitant Medications:

Tyrvaya 0.03mg/spray nasal spray every 12 hours, ursodiol 300mg, pravastatin 80mg, omeprazole 40mg, metoprolol 25mg, hydrochlorothiazide 25mg, finasteride 5mg, doxepin 10mg, cyclobenzaprine 10mg, amlodipine 5mg, and allopurinol 100 mg

Diagnosis:

Neurotropic keratitis OS, nuclear sclerosis OS, macular scar OS

Treatment:

The patient was treated with Prokera x 5 days, then a second Prokera x 5 days, then cenegermin-bkbj x 10 weeks. At the 10-week follow-up, corneal sensation was restored, and no punctate keratitis was observed. The patient was then referred for a cataract consultation.