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Unilateral Punctate Keratitis Secondary to Wallenberg Syndrome
Pino Cidad,Ana Boto,Almudena Del Hierro,Maria Capote,Susana Noval,Amanda Garcia,Susana Santiago 대한안과학회 2014 Korean Journal of Ophthalmology Vol.28 No.3
We studied three patients who developed left unilateral punctate keratitis after suffering left-sidedWallenberg Syndrome. A complex evolution occurred in two of them. In all cases, neurophysiologicalstudies showed damage in the trigeminal sensory component at the bulbar level. Corneal involvementsecondary to Wallenberg syndrome is a rare cause of unilateral superficial punctate keratitis. The lossof corneal sensitivity caused by trigeminal neuropathy leads to epithelial erosions that are frequentlyunobserved by the patient, resulting in a high risk of corneal-ulcer development with the possibility ofsuperinfection. Neurophysiological studies can help to locate the anatomical level of damage at theophthalmic branch of the trigeminal nerve, confirming the suspected etiology of stroke, and demonstratingthat prior vascular involvement coincides with the location of trigeminal nerve damage. In some of thesepatients, oculofacial pain is a distinctive feature.