The present methods of treatment of neuroparalytic keratitis, though effective, are cumbersome. They interfere with vision and are a nuisance to the patient. Reduction in the secretion of tears is a recognized feature in these cases. Because of the inadequate supply of tears, evaporation leads to dryness and corneal damage. Any measure preventing drying leads to healing. Verhoeff1 kept the affected eye moist with Ringer's solution, and the corneal epithelium was rapidly restored. Suturing the lids reduces evaporation of tears, and corneal lesions clear. The use of castor oil or liquid or solid petrolatum serves the same purpose, as does also Buller's shield2 or special protective goggles.
Our studies have convinced us that although the cornea is anesthetic the diminished secretion of tears is the primary factor in the evolution of these corneal lesions. Blocking the canaliculi prevents the escape of tears into the lacrimal sac
MacMILLAN JA, CONE W. PREVENTION AND TREATMENT OF KERATITIS NEUROPARALYTICA BY CLOSURE OF THE LACRIMAL CANALICULI: REPORT OF A CASE. Arch Ophthalmol. 1937;18(3):352–355. doi:10.1001/archopht.1937.00850090020002
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