Abstract
Neurotrophic keratopathy (NK) is a devastating, chronic disease in which an underlying insult or injury impairs corneal sensation. As corneal nerves play a critical role in the delicate homeostasis of ocular surface maintenance, any lack of corneal sensitivity triggers a cascade of events that leads to epithelial breakdown and ultimately stromal degradation. While the fundamental definition, clinical evaluation, and classification of the disease have not changed much, significant advances in the understanding of disease pathophysiology and potential treatment targets have been made over the last decade. These innovations in the management of this condition continue to transform the prevailing practice patterns due to increasing insights into mechanisms of disease pathogenesis and progression. In this chapter, we review the underlying etiologies, clinical diagnosis, and current as well as emerging therapeutic options for NK, with a focus on the recent adjustments in the treatment paradigm.