Long-Term Monitoring of Patients With NK

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Long-term neurotrophic keratitis (NK) management emphasizes comprehensive ocular surface support following successful epithelial healing. Treatment approaches mirror dry eye management protocols, including anti-inflammatory medications such as cyclosporine or lifitegrast, mild topical steroids when appropriate, and meticulous avoidance of benzalkonium chloride-containing products. Autologous serum tears provide valuable maintenance therapy, though cost and regulatory limitations may necessitate alternative pharmaceutical options covered by insurance.

Follow-up scheduling follows a structured timeline beginning with midtreatment evaluation during cenegermin therapy, followed by assessment shortly after completing the 8-week course. Subsequent visits occur at 3 months, 6 months, and annually, with intervals extending to every 6 to 12 months once stability is established. This schedule enables early detection of recurrence while avoiding excessive medical visits for patients whose disease is stable.

Patient education plays a crucial role in long-term success, focusing on the recognition of recurrence symptoms, particularly persistent blurry vision in the absence of pain or significant discomfort. Patients learn that NK recurrence may present subtly without dramatic symptoms, making visual changes an important warning sign. Early intervention upon symptom recognition prevents progression to advanced stages and enables prompt treatment reinitiation when necessary.