corneal neurotrophic ulcer

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Ophthalmology A corneal ulcer 2º to a loss of sensory innervation of the cornea, leading to ↓ number of corneal stem cells, ↓ rate of metabolism and mitotic activity, resulting in ↑ corneal permeability, and ↓ acetylcholine and acetyltransferase Etiology 5^th nerve palsy, viral infections, chemical burns, corneal surgery, abuse of topical anesthetics, neurotrophic keratitis, DM, multiple sclerosis Management Nerve growth factor may be effective; other modalities–eg, covering the cornea with a patch or a soft contact lens, tarsorrhaphy with conjunctival flap are largely ineffective

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