Is this neurotrophic keratitis?

This My Question:

Is this neurotrophic keratitis?

I was diagnosed with MS in 2013, symptoms in 2011. I have several areas of demyelination on brain MRI and c-spine at C1 and C5-6. I was seen by ophthalmology in 2016 for eye redness without discharge. I had keratitis and was given steroid drops. I was recently seen again and diagnosed with keratitis with corneal ulcer and treated with steroid eye drops.

I have had similar issues in the past two years but did not seek treatment because there was no drainage, it was not that uncomfortable and resolved in 3-5 days on its own. I asked my ophthalmologist if this was related to MS and was not given an answer. I do not wear contacts, have not injured my eyes. I did have lasik surgery about 10 or so years ago. My eyes may get a little dry but I have never been diagnosed with dry eye. I will see my neurologist in January, is there anything I should be asking him to evaluate or is not related to MS?

Answer:
This would only be considered neurotrophic keratitis if you have damage to your trigeminal nerve, leading to denervation of the cornea (lack of sensation in the cornea).

Typically in MS trigeminal nerve issues manifest not as neurotrophic keratitis but rather as trigeminal neuralgia, an extremely painful form of headache/facial pain.

Usually with neurotrophic keratitis, the trigeminal nerve dysfunction causes numbness/lack of sensation and this lack of sensation in the face and in particular the cornea leads to the keratitis.

You can see a cornea specialist or neuro-ophthalmologist to try to figure this out.

Benjamin Osborne, MD
Associate Professor of Neurology and Ophthalmology
Director, Neuromyelitis Optica (NMO) and Neuro-Ophthalmology Clinics
Associate Director of the NIH/Georgetown Neurology Residency Program
Medstar Georgetown University Hospital