Unilateral pediatric neurotrophic keratitis due to congenital left trigeminal nerve aplasia with PROSE (prosthetic replacement of the ocular surface ecosystem) treatment

• Main Authors: Sarah M. Kamal, Kellen Riccobono, Alan Kwok, Jane C. Edmond, Stephen C. Pflugfelder
• Format: Article
• Language: English
• Published: Elsevier 2020-12-01
• Series: American Journal of Ophthalmology Case Reports
• Subjects: Pediatric neurotrophic keratitis; PROSE lens; Congenital trigeminal nerve aplasia
• Online Access: http://www.sciencedirect.com/science/article/pii/S2451993620301699

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.