Key takeaways:
- Neuropathy and irritation work collectively to drive widespread manifestations of corneal illness.
- Early intervention might help.
LOS ANGELES — Ophthalmologists ought to act early to stop a “vicious” cycle of neuropathy and irritation in corneal illness, in line with a speaker on the American Society of Cataract and Refractive Surgical procedure assembly.
On this yr’s Richard L. Lindstrom, MD, Lecture, Reza Dana, MD, MPH, MSc, stated neural dysregulation and irritation “co-conspire” to induce ocular floor pathology.
Reza Dana, MD, MPH, MSc, (heart), receives the Lindstrom Medal from Richard L. Lindstrom, MD, (proper) and Marjan Farid, MD.
“One amplifies the opposite, they usually result in corneal illness,” Dana stated. “The commonest manifestations of that dysfunction — ache, redness, dry eye, corneal neovascularization or angiogenesis, and even endothelial illness — are linked, as you’ll see, with neuropathy and irritation.”
Dana stated the cornea has a dense community of nerves in addition to immune cells, and immune-based epitheliopathy, seen in widespread circumstances corresponding to dry eye illness and unusual circumstances corresponding to Stevens-Johnson syndrome, is carefully associated to neuropathy.
He described a cycle of irritation, neuropathy and epithelial illness, in addition to the mechanisms that result in typical corneal pathologies, together with ache and redness, angiogenesis and endothelial illness.
In sufferers with any manifestation of epithelial illness, Dana instructed offering lubricants and ocular floor optimization as quickly as attainable. For sufferers with any manifestation of neuropathy, he stated to used biologics, together with recombinant nerve progress issue and autologous serum.
For irritation, he urged even handed use of anti-inflammatories, particularly “mushy” steroids moderately than potent corticosteroids.
“The implication for all of you, whether or not you’re a cornea, cataract or any ophthalmologist, is that once you see sufferers early on which have any signal of neuropathy or epithelial illness or irritation, the important thing level is to stop this vicious cycle from taking maintain,” Dana stated. “You need to intervene early.”
Sources/Disclosures
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Dana R. The Lindstrom Lecture. Offered at: American Society of Cataract and Refractive Surgical procedure assembly; April 25-28, 2025; Los Angeles.
Disclosures:
Dana reviews no related monetary disclosures.
