What Is Neurotrophic Keratitis | Eye Doctor Explains
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- Опубліковано 16 кві 2021
- In this video, Dr. D talks all about neurotrophic keratitis (or NK). She discusses what she sees in clinic, what causes it, and how she treats it.#neurotrophickeratitis #nk
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amniotic membrane, bacterial keratitis, what is neurotrophic keratitis, viral keratitis, amniotic membrane for dry eye
Corneal neurotization is effective for restoring sensory innervation and increase the Corneal Sub-Basal Nerves. Go for if you want your eye(s) to back to almost normal since Corneal nerves evoke the blink/tearing reflexes and release neuropeptides, which aid in maintaining epithelial cell integrity.
Just finishing my 5th day of Oxervate. I’m praying this helps me. I’ve had dry eyes for about 8 years with no tear production due to Rheumatoid Arthritis. All I make is mucus that then dries on my eyes and then scratching my corneas. I’ve done two amniotic membrane patches on my right eye also.
Great video. Love how you explain some key differences with what dry eye vs NK looks like. 👍🏻
I have recently been diagnosed with NK, your video was very helpful! In helping me understand what is going on with my eyes.
Thank you.I am starting to the Oxervate tomorrow.Your video was very helpful..
Excellent presentation. Thanks
hi dr, thanks for making this video. I had lasik in 2011 and have severe dry eyes. I came across a usage for oxervate to help stimulate nerve growth and help address the underlying issue in lasik dry eyes and was interested on your thoughts. I spoke to an opthamologist the other day and discussed this. He said he would have to refer me to a cornea specialist to prescribe it. Additionally, the side effect which concerns me is corneal deposits, if you could comment on that it would be greatly appreciated, thank you.
Great information, THANK YOU .....is cataract surgery contraindicated with for people with NK?
I use peppermint oil on corners of eyes and across forehead.. Should use a base oil mix to keep from burning tissue
Great video! Thank you
You are welcome! 😍
I've recently been diagnosed with NK in both eyes. I have bilateral trigeminal neuralgia and had Lasik. My sensitivity is absent. My corneal specialist immediately inserted punctal plugs in both eyes in both upper and lower ducts. I'm using Klarity-C, steroid drops, plus ointment at night and PF drops during the day. I realize I must keep it from getting worse, but is there any chance of it getting better or resolving?
Oxervate vs Cryopreserved Amniotic Membrane (CMA), would patients need BOTH? any difference between these two, since Oxervate is soso expensive although seems effective. A real expert who cares for patients examines cornea nerve to stop progression. Thanks for sharing.
CMA's were all we had before Oxervate came out. They do work, but are short term (corneal defects will come back if the nerves are still damaged). Oxervate helps the nerves regenerate and is much preferred to CMA's in my opinion. Although clinically there are pros and cons to each and it would depend on the specific clinical findings + patient situation.
@@EyeSchoolwithDrD Thank you so much for such important information.
@@eaglec.8865 It works wonders! I will cross my fingers for access for you!
Dear Dr, how do you detect the inflammation, dyes or MMP-9 or both? Seems MMP-9 is more reliable than the dyes, especially most drs do not wait for 2min. Thank you.
I use both! Because staining can be for other reasons or someone can have the inflammation but no staining on that day
I was diagnosed with no I have had my left eye stitched in the middle for 6 months and right eye also about 3 months don’t know how or why I got this other than a mean case of Amyloidosis however in remission has resided effects on nerves in the entire body I’m losing hope of being able to see again I can’t drive or see my phone or my television anymore and I can’t work I spend loads of money on eye drops that don’t work I want to see again and my eye special doesn’t see me regularly last time I saw him was in May it’s almost august now I need help
Thanks a lot - Great Video!! NK has recently been diagnosed by confocal microscopy. Is overvate available in Europe (particularly in Germany), or is this FDA approved treatment only available in the US?
Ich habe auch Keratitis, die Hornhaut ist nicht empfindlich und einige der Hornhautnerven fehlen.Der Arzt sagte, dass Oxervat nicht verschrieben wird.Ich kann nicht verstehen, warum es in Amerika möglich ist, aber nicht in Europa.
@@valyaro9705 vielen Dank! Ich habe am 02.08. meinen nächsten Arztzermin und werde danach fragen. M.W. kann ab mittlerer Keratitis (Hornhauterosionen und Ähnliches) dies verordnet werden. Interessant wäre aber, ob auch leichtere Fälle hiermit gute Heilungschancen haben, dann könnte man ggf. überlegen, das selbst zu zahlen, wobei ich bei den Kosten(8TEUR bis 20TEUR, je nach Information) doch tendenziell zurückschrecke...ich vermute, zu den Heilungschancen in Ihrem Fall hat sich Ihr Arzt nicht geäußert?
Wie geht's Ihnen?Was hat den Arzt gesagt?
Was gehts Ihnen? Was hat den Arzt gesagt?
@@valyaro9705 Leider nichts Neues. „Ist bei Ihnen nicht indiziert, verschreibe ich nicht“ war die Antwort.
Dear Dr, How do you detect if EPITHELIAL defect presents? fluorescein & lissamine green? Thanks.
Fluoroscein and lissamine green, yes. Instill, observe tbut then wait and observe epithelial defect staining on cornea
You're a great expert because you use BOTH dyes to detect/solve problems.What symptoms when one has epithelial defect? light/wind sentativity? What key things one can do to improve it?
Is there a condition where your ocular nerves are in constant, unrelentless pain? How can you know if you have this diagnoses? And is there hope for people with the disorder?
i am not a dr but def think you should see an optometrist or ophthalmologist for further work up. there is a condition in which that can occur. have you had eye surgery ?
What’s SPK ? Is this curable ?
When one has NK or Neuropathic corneal pain, most likely positive MMP-9 or not necessary? Thank you
Not necessarily.
Dear Dr, does NCP occure BEFORE NK or NOT necessary? Their symptoms are smiliar & the only difference is with staining, right?
@@eaglec.8865 Ok this is complicated and easy to confuse. Neurotrophic Keratitis means the nerves aren't working as well. Post-LASIK, Post-surgery, long time CL wear, Dry Eye, prior Simplex/Zoster. These patients will feel nothing (corneal hypoesthesia) and their corneas will stain terribly or they'll have ulcers with rolled edges. There's something else that's easy to confuse. In fact I may have done it in a prior reply to you. Corneal neuralgia is pain without stain (this is what I may have mixed up in past in a comment to you...but clarifying now). So those patients feel a lot of pain but their eye looks fine to us. Clinically, either one could have a positive MMP9 but wouldn't have to. Usually my NK patients do especially if they are post-LASIK. Usually they are the opposite- NK is less pain + stain. Neuralgia is pain and no stain or minimal stain. Clear as mud? Lol...
Not easy to understand but wonder perhaps NO STAINING is because drs do NOT wait for 2-3 min with dyes, proper filters, or right concentration of dyes?
As you said, it develops slow so how could drs miss it in the first place? In short, the only way to prevent progression: FIND a real expert who has update knowledge & passion to detect trigger. Thanks a million.
@@eaglec.8865 Yes, all possibilities. Using no dye at all, the wrong amount or not waiting 2 mins impact what you see clinically. Also, YES we do miss it because these two conditions are TRICKY. In addition, for NK, you really need to test corneal sensitivity with a cotton wisp and its not common practice to do so unless patient presenting with Herpes Simplex suspected or if corneal staining not getting better.
Hi Dr. D
I was recently prescribed Oxavate by Dr. bos in Los Angeles. But I’m really really scared, to try
He did exactly what you said, where he pulled on a sterile Q-tip, until it was nothing but a string , he rubbed against my right eye, and I immediately felt it and jerked back. He tried it again on my left eye, and I didn’t feel a thing. He tried it again three more times, and again I didn’t feel a thing. I have traveled the country, seeking relief for this horrible pain. I’ve gone to see Dr. Steve Maskin in Florida. I’ve gone to see Dr. Pedram Hamrah in Boston. It seems that I have put so much drugs in my body and enough different drops in my eyes to fill the Pacific Ocean. I’m so scared to try this. Do you think something like this will help the extreme pain in the eyes. It kind of feels like somebody poured acid in my eyes, or rubbed them against sand paper and lite them on fire. My left is certainly worse then my right. I was told that after the first few days on oxavate the pain might get worse before it gets better. Pls help
Hi there. I have used oxervate extensively in patients with both underactive and overactive corneal nerves, and I do feel that it helps greatly. It is made of nerve growth factor, and I have seen it normalize corneal nerve function in a variety of patients. PRP drops and high concentration autologous serum can help as well. Also, I have also seen great results with the new Versea 3L amniotic membrane grafts. Hope that helps. Let me know!
Is NK the same as Neuropathic dry eye?
No, NK is degenerative and results in loss of corneal sensitivity, often from prior trauma, surgery, contact lens wear, or systemic consitions. Neuropathic corneal pain is when you have more pain than symptoms - an overfiring of the nerves.
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