Mackie Classification of Neurotrophic Keratitis

Cornea & Ocular Surface
Written By Madhuvanthi Mohan

  • Corneal innervation by the trigeminal nerve (5th cranial nerve) is impaired.

  • Partial or complete loss of corneal sensation can result in epithelial keratopathy, epithelial defect, stromal ulceration, and eventually corneal perforation.


TREATMENT: (According to stages of Mackie Classification).

Stage 1:

  • Withdrawal of epitheliotoxic drugs, preservative-free lubricating drops, BCL, Oral tetracycline/doxycyline.


Stage 2:

  • Preservative-free lubricants and ointment

  • Growth factors

  • Autologous serum eyedrops

  • Patching

  • Tarsorrhaphy


Stage 3:

  • Collagenase inhibitors (tetracycline, Vitamin C).

  • Cyanoacrylate glue with BCL.

  • Conjunctival Gunderson Flap.

  • Amniotic Membrane Grafting.

  • Penetrating Keratoplasty.



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Image from Rajan Eye Care Hospital

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Madhuvanthi Mohan
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