Assessing NK Corneal Sensitivity

EP: 1.Differential Diagnosis of NK

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EP: 2.Assessing NK Corneal Sensitivity

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Multiple approaches exist for assessing corneal sensitivity, ranging from simple qualitative methods to sophisticated quantitative instruments. Francis Mah, MD,advocates for the cotton-tipped applicator (Q-tip) method due to its universal availability and ease of use, making it accessible in any clinical setting. While this approach provides qualitative rather than quantitative results, its simplicity ensures that practitioners can consistently incorporate sensitivity testing into their routine examinations without requiring specialized equipment.

Lauren McLoughlin, OD, utilizes both traditional cotton swab testing and the more advanced Brill noncontact esthesiometer, which offers 5 distinct sensitivity levels. The quantitative instrument provides value in detecting early NK through its ability to identify hypersensitive patients (those feeling level 1, which normal patients shouldn't detect) and definitively diagnose desensitization (patients not feeling levels 4 or 5). This graduated approach allows for more precise staging and monitoring of NK progression over time.

The critical message transcends the specific method chosen: The importance lies in consistently thinking about and performing corneal sensitivity testing. Whether using cotton swabs, dental floss, or sophisticated instruments, the key is establishing a routine practice of sensitivity assessment. This systematic approach enables early detection of NK, which significantly improves patient outcomes through timely intervention and appropriate treatment selection.