Neurotrophic keratitis (NK) is one of the most challenging corneal conditions to manage — and one where the right specialty scleral lens can make a profound difference. When the cornea loses its sensation, it also loses its ability to protect and heal itself. At Michigan Contact Lens, Dr. Shira Kresch fits protective scleral lenses that hydrate, shield, and stabilize a vulnerable cornea while your medical treatment addresses the underlying cause.
Neurotrophic keratitis is a degenerative disease of the cornea caused by damage to the trigeminal nerve — the nerve responsible for corneal sensation. When the cornea can no longer feel, it loses the protective reflexes that keep it healthy: blinking, tear production, and the natural drive to heal minor injuries.
The result is a surface that gradually breaks down, developing persistent epithelial defects, ulcers, and — if left untreated — scarring and permanent vision loss. Because the cornea cannot signal pain, NK often progresses silently, which is why specialized monitoring and protection are so important.
Neurotrophic keratitis develops when the corneal nerves are damaged or interrupted. Common causes include:
If you have any of these risk factors and notice changes in your vision or comfort, a specialized corneal evaluation is worthwhile — even if your eye doesn’t hurt.
Because reduced sensation is a hallmark of the disease, symptoms can be deceptively mild. Watch for:
For a cornea that can’t protect or heal itself, a scleral lens does the work the eye no longer can. The lens vaults completely over the cornea and holds a reservoir of sterile fluid against the surface throughout the day.
Scleral lenses are used alongside medical therapy — they protect and stabilize the eye while the underlying nerve condition is treated.
In earlier or milder cases, or between stages of treatment, other protective lenses may play a role. Bandage soft lenses can temporarily cover and protect a healing surface, while specialty designs bridge the gap until a full scleral lens is the right fit. Dr. Kresch selects the safest option for the current health of your cornea.
Neurotrophic keratitis is best managed as a team. Michigan Contact Lens co-manages NK with ophthalmologists and corneal surgeons across Metro Detroit, coordinating lens care around your medical treatment — whether that’s medication, amniotic membrane therapy, or surgical intervention. Early, coordinated care offers the best chance of protecting your vision.
The underlying nerve damage is managed rather than fully cured, but the disease can be controlled and your vision protected. Scleral lenses play a major role by shielding and hydrating the cornea while medical therapy addresses the cause.
Yes. Because scleral lenses vault over the cornea and never touch it directly, they’re one of the safest options for a fragile surface. The fluid reservoir actively protects and hydrates the eye all day.
Absolutely. We co-manage neurotrophic keratitis with ophthalmologists and corneal surgeons, coordinating lens care around your medical treatment plan.
Many patients regain significant clarity once the surface is protected and stabilized. Outcomes depend on how much scarring has already occurred, which is why early specialized care matters.
