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

Sarah M Kamal; Kellen Riccobono; Alan Kwok; Jane C Edmond; Stephen C Pflugfelder

doi:10.1016/j.ajoc.2020.100854

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

Am J Ophthalmol Case Rep. 2020 Aug 3:20:100854. doi: 10.1016/j.ajoc.2020.100854. eCollection 2020 Dec.

Authors

Sarah M Kamal¹, Kellen Riccobono², Alan Kwok², Jane C Edmond³, Stephen C Pflugfelder¹

Affiliations

¹ Department of Ophthalmology, Baylor College of Medicine, 1 Baylor Plaza, Houston, TX, 77030, USA.
² Boston Sight, 464 Hillside Ave, Needham, MA, 02494, USA.
³ Department of Ophthalmology, Dell Medical School, University of Texas at Austin, 1701 Trinity St, Z1200, Austin, TX, 78712, USA.

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.

Keywords: Congenital trigeminal nerve aplasia; PROSE lens; Pediatric neurotrophic keratitis.

Publication types

Case Reports