A 58-year-old patient with lagophthalmos following Bell's palsy develops a persistent inferior corneal epithelial defect without significant inflammation. Fluorescein staining shows a triangular defect with smooth, rounded edges and minimal stromal infiltrate. What is the most likely diagnosis?
- A Neurotrophic keratopathy ✓
- B Bacterial keratitis
- C Herpes simplex epithelial keratitis
- D Mooren ulcer
Correct answer: A. Neurotrophic keratopathy
Explanation
Neurotrophic keratopathy from trigeminal denervation produces a sterile, non-inflammatory epithelial defect with smooth rounded edges, classically inferiorly placed. It follows lid closure failure or sensory loss. Bacterial keratitis and HSV epithelial keratitis show rougher margins with surrounding inflammation. Mooren ulcer is peripheral with undermined edges.
Reference: AAO BCSC Section 8: External Disease and Cornea, 2022-2023 ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.