American Journal of Ophthalmology Case Reports (Dec 2020)
Unilateral pediatric neurotrophic keratitis due to congenital left trigeminal nerve aplasia with PROSE (prosthetic replacement of the ocular surface ecosystem) treatment
Abstract
Purpose: To present a 3-year-old female patient with a non-familial, isolated, unilateral case of left corneal anesthesia with MRI-confirmed congenital left trigeminal nerve aplasia. Observations: A corneal epithelial defect was noted in the left eye after an 8-week trial of recombinant human nerve growth factor. Subsequent evaluation and fitting of a PROSE (prosthetic replacement of the ocular surface ecosystem) lens led to healing of the corneal epithelium and visual acuity improvement from 20/300 to 20/70. Conclusions and Importance: A scleral lens may be a possible treatment for those with neurotrophic keratitis in which a trial of topical lubrication and human nerve growth factor has not been effective.