Trigeminal sensory neuropathy developing as a late complication after the treatment of surgically induced necrotizing scleritis following pterygium surgery: a case report and literature review.
Buğra Karasu, Nilay Kandemir Beşek, Enes Kesim et al.
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Case in brief
A 31-year-old woman developed right-eye irritation, reduced vision, and photophobia after bilateral pterygium surgery. Examination showed melting of the conjunctival autograft with exposed sclera and a visible choroidal reflex. Repair with an amniotic membrane failed, and a pericardial patch was used to cover the scleral defect. Rheumatological evaluation found no underlying systemic disease. Despite treatment for surgically induced necrotizing scleritis, she had persistent photophobia, dental pain, and headache. Three months after her third surgery, neurology diagnosed painful post-traumatic trigeminal neuropathy; symptoms responded to oral gabapentin.
What made this case unusual
The report describes painful post-traumatic trigeminal neuropathy as a late complication following surgically induced necrotizing scleritis after pterygium surgery.
Diagnostic / clinical pearl
Persistent photophobia or other pain despite treatment of scleritis may warrant consideration of trigeminal sensory neuropathy, particularly when symptoms include dental pain and headache.