Thelansis

Neurotrophic keratitis (NK) is a degenerative corneal disease caused by trigeminal nerve (cranial nerve V) damage, resulting in corneal sensation loss and breakdown of the corneal epithelium. Corneal healing is also hampered in NK, so superficial corneal damage may progress to an actual epithelial defect, followed by corneal ulceration, stromal melting, and perforation. NK treatment aims to restore corneal integrity and prevent the disease from progressing. The cornea, lacrimal glands, conjunctiva, and eyelids are innervated by sensory branches of the ophthalmic division of the trigeminal nerve. The corneal epithelial cells mutually support the corneal nerves by releasing neurotrophic factors that promote neuronal extension and survival. The corneal nerves initiate two protective reflexes, blinking and tear secretion, responding to adverse stimuli. The nerves also support ocular surface health by releasing a host of trophic neuromediators, including substance P and calcitonin gene-rela...