Clinical Pearls for NK Detection and Treatment

Video content above is prompted by the following:

The fundamental principle for NK detection involves maintaining high clinical suspicion based on patient history and presentation patterns. Certain historical factors should automatically trigger NK consideration, including diabetes, herpes simplex keratitis, chronic glaucoma medication use, and previous ocular surgeries. When these risk factors combine with characteristic symptoms such as painless vision changes or minimal discomfort despite significant corneal staining, NK diagnosis becomes highly probable even before sensitivity testing confirmation.

Corneal sensitivity testing represents the definitive diagnostic step, but the clinical context often predicts results before testing occurs. Experienced practitioners develop pattern recognition enabling NK suspicion before examination, with sensitivity testing serving as confirmation rather than initial consideration. This systematic approach ensures consistent NK evaluation in appropriate patients and prevents missed diagnoses in subtle presentations.

Documentation strategies significantly impact insurance approval processes for cenegermin therapy. Comprehensive recording of previously failed treatments, detailed symptom descriptions, clear staging information, and systematic corneal sensitivity documentation provide insurance companies with the necessary justification for expensive specialty medication approval. Having dedicated prior authorization staff familiar with NK documentation requirements streamlines the approval process and reduces delays in treatment initiation.