Title: Multi-Disciplinary Approach in a Case of Neurotrophic Keratitis with Vestibular Schwannoma and Seventh Cranial Nerve Palsy

Authors: Dr Debasmita Bera, Dr Soumya Ray, Dr Indrajit Sarkar, Dr Mousumi Bandyopadhyay

 DOI: https://dx.doi.org/10.18535/jmscr/v7i2.122

Abstract

Multidisciplinary  approach  is  essential  in  some  cases  of  keratitis as here we required  multidisciplinary approach for a 54  yrs  female  reported to OPD with diminished vision, lagophthalmos &  neurotrophic  keratitis of  Right eye  along with other features of seventh  cranial  nerve palsy. On detailed clinical & radiological investigation patient was provisionally dignosed having vestibular schwannoma. Patient had   undergone right retromastoid-suboccipital craniotomy and subtotal excision of the mass confirmed histopathologically to be vestibular  schwannoma. Lateral   tarsorrhaphy was done as well as medical treatment was also given to protect vision. 6 week follow up revealed neurotrophic keratitis healed, residual corneal opacity remained. Vision improved to 6/36. Exposure keratitis as well as neurotrophic keratitis can also occur due to various intracranial causes, we need to find & treat the cause, multidisciplinary approach can save life as well as improve quality of life.

Keywords: vestibular schwanoma, seventh nerve palsy, neurotrophic keratitis.

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