How does damage to the trigeminal nerve cause neuroparalytic keratitis?

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eye disease An ophthalmologist performing LASIK eye surgery.

Neuroparalytic keratitis is an inflammation of the cornea that occurs following the interruption of sensory impulses transmitted by the fifth cranial nerve, also known as the trigeminal nerve.

The primary mechanism of this condition is the loss of corneal sensitivity. Because the eye can no longer detect irritation or injury, it becomes significantly more vulnerable to external trauma, environmental exposure, and secondary infections. If left unmanaged, this lack of sensation often leads to corneal ulceration and impaired vision. In severe cases, the process may progress to a perforation of the eyeball, which could necessitate enucleation, or the surgical removal of the eye. Treatment typically focuses on protecting the compromised surface through the intensive use of eye lubricants and the administration of antibiotics if a secondary infection develops.1