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

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.