title: Bilateral neurotrophic keratopathy complicating Vidian neurectomy.
abstract: OBJECTIVE
  To present a case of bilateral neurotrophic keratopathy with miosis after bilateral Vidian neurectomy for vasomotor rhinitis.
  
  
  METHODS
  Observational case report.
  
  
  RESULTS
  A 68 year-old man presented with irritation and blurred vision in both eyes 2 weeks after bilateral Vidian neurectomy. Slit-lamp examination revealed a large epithelial defect, typical of neurotrophic keratopathy, in the inferior two-thirds of cornea in both eyes. Corneal sensitivity test with a Cochet-Bonnet anesthesiometer and electrical study of the blink reflex indicated bilateral trigeminal dysfunction. Both pupils were miotic, and tests with hydroxyamphetamine 1% and epinephrine 0.1% showed postganglionic sympathetic nerve damage. The corneal epithelial defects healed after 2 months of treatment with systemic prednisolone, vitamin B(12) and tarsorrhaphy.
  
  
  CONCLUSIONS
  Neurotrophic keratopathy associated with dry eye syndrome may be a serious complication of Vidian neurectomy.
authors: Department of Ophthalmology, Taipei Veterans General Hospital and National Yang-Ming University, Taipei, Taiwan. pylin@vghtpe.gov.tw
authors: P Y
authors: PY
authors: Lin
authors: C Y
authors: CY
authors: Cheng
authors: C C
authors: CC
authors: Wu
authors: M Y
authors: MY
authors: Yen
authors: S J
authors: SJ
authors: Wang
authors: K K
authors: KK
authors: Liao
authors: S M
authors: SM
authors: Lee
mesh_terms: D000368:Aged; D003315:Cornea / Q000294:innervation*; D003316:Corneal Diseases / Q000209:etiology*; D006261:Headache / Q000209:etiology; D006801:Humans; D008297:Male; D015877:Miosis / Q000209:etiology; D009297:Nasal Mucosa / Q000294:innervation*; D017764:Parasympathectomy / Q000009:adverse effects*; D010275:Parasympathetic Nervous System / Q000601:surgery*; D012223:Rhinitis, Vasomotor / Q000601:surgery; D020433:Trigeminal Nerve Diseases / Q000209:etiology*