Posters

Neurotrophic ulcer post-surgery of trigeminal neuralgia: about a case

Poster Details

First Author: M.Hassoune MOROCCO

Co Author(s): D. Hamidallah   I. Hanafi   C. Baqadir   L. Elmaaloum   B. Allali   A. Elkettani     

Abstract Details

Purpose:

Neurotrophic keratopathy is a partial or complete denervation of the cornea from various origins; may cause disorders of corneal sensitivity and chronic degenerative damage to the corneal epithelium; can be complicated by chronic ulcers that can go as far as perforation. This is a relatively rare pathology that presents a problem of management

Setting:

Corneal neurotropic ulcers are a serious entity and may compromise the anatomical integrity of the ocular surface and the transparency of the cornea can cause a deep and lasting decrease in Visual Acuity

Methods:

A 57-year-old woman, followed for trigeminal neuralgia, operated 6 months ago with a thermal coagulation of Gasser's ganglion in neurosurgery; goes to the emergency for Painless red eye and decreased visual acuity in the left eye for 20 days

Results:

Examination of the left eye finds visual acuity at CLDL; Conjunctival hyperemia with central epithelio-stromal ulcer 8mm / 7mm and peri-lesional edema. the Corneal sensitivity was abolished the patient was put under: eye wash; Autologous serum; wetting agents; Soft lens port during the day and daily supervision. the evolution was marked by a beginning of reepithelialization at the 5th Day of the treatment and a total reepithelialization at 32th Day ; the patient retained a para-axial corneal opacity with visual acuity corrected to 1/10.

Conclusions:

Trigeminal neuralgia surgery is a classic etiology of neurotrophic ulcers but other etiologies are described including V Paralysis (aneurysm, post-traumatic, post-surgical, tumoral, hereditary ...), Infectious (Herpes simplex, herpes ZONA), Diabetes, System Illness ... The initial clinical presentation is a decrease in visual acuity, conjunctival hyperemia, tearing, and lack of corneal sensitivity Treatment must be fast and aggressive. There is No specific treatment :Wetting agents whatever the stage ; Eviction of eye drops with preservatives and local corticosteroids ; Autologous serum; Therapeutic soft lens, scleral glass ; and amniotic membrane in case of perforation.

Financial Disclosure:

None