Neurotrophic Keratitis in Focus: Diagnosis, Treatment and Practice Pearls

Panelists discuss how to differentiate neurotrophic keratitis (NK) from dry eye disease and blepharitis by focusing on patient history, chief complaints, and the critical importance of corneal sensitivity testing.

Panelists discuss how to perform corneal sensitivity testing using methods ranging from cotton swabs to the more quantitative Brill esthesiometer, emphasizing that testing should become routine practice.

Panelists discuss how early recognition of stage 1 neurotrophic keratitis (NK) leads to better treatment outcomes and how to identify key risk factors, including diabetes, herpes infections, and long-term glaucoma medication use.

Panelists discuss how they use staging systems, such as the Mackie classification (mild, moderate, severe), and incorporate corneal sensitivity testing into comprehensive eye exams for better risk stratification.

Panelists discuss how their treatment approach progresses from amniotic membranes for mild cases to cenegermin-bkbj for more advanced stages, with serum tears used for maintenance therapy.

Panelists discuss how cenegermin-bkbj has become their first-line therapy due to its effectiveness, accessibility, and durability, fundamentally changing their approach to dry eye treatment.

Panelists discuss how they treat patients with neurotrophic keratitis (NK) with comorbidities by coordinating with glaucoma specialists, minimizing preservatives, and temporarily discontinuing contact lens wear during treatment.

Panelists discuss how they monitor healed patients with supportive ocular surface treatments, close follow-up schedules, and patient education about recognizing early recurrence symptoms.

Panelists discuss how they educate patients about neurotrophic keratitis (NK) using analogies such as "cut phone lines" to explain nerve damage and prepare patients for the 8-week treatment process and potential adverse effects.

Panelists discuss how the key to successful neurotrophic keratitis (NK) management lies in thinking about the condition when reviewing patient history and making corneal sensitivity testing a routine part of ocular surface examinations.

Panelists discuss how cenegermin has opened the door for other companies to research neurotrophic keratitis (NK) treatments, with emerging therapies such as topical insulin and lacrimal gland injections showing promise.