Exposure Keratitis and Cranial Nerve VII Palsy
Patients with paralytic or mechanical eyelid abnormalities may have significant corneal dryness, which may be exacerbated by cataract surgery. Administration of topical anesthetics preoperatively may desiccate the corneal epithelium. A peribulbar or retrobulbar block can produce a neurotrophic cornea that persists for hours after surgery; a large corneal abrasion may also develop, unless a pressure patch is applied. Lubrication with antibiotic ointment may be necessary in the early postoperative period to facilitate healing of the epithelial surface and to control pain from an abrasion. Extended-wear therapeutic contact lenses can promote rapid healing of the epithelium and can be employed as a moisture chamber in cases of exposure keratitis, in conjunction with preventive local antibiotic treatment and patient adherence.
Excerpted from BCSC 2020-2021 series: Section 11 - Lens and Cataract. For more information and to purchase the entire series, please visit https://www.aao.org/bcsc.