Bilateral Exposure Keratopathy

Image 1 – Patient presented with bilateral exposure keratopathy secondary to mild lagophthalmos, incomplete blinking and large apertures. No relief of symptoms with OTC artificial lubricants, gels, and nighttime ointments.

Image 2 – A 12mm Ophthalogix amniotic membrane graft was cut using sterile surgical scissors after the packet was opened. Topical anesthesia was applied 2 mins prior. AM graft was applied to localized areas of defect bilaterally sparing the pupil and bandage contact lens was placed. Patient closed eyes for 2 mins.

Image 3 – After 24 hours, amniotic graft was fully broken down. Bandage contact lens is still in place and moving well with regimen of preservative-free artificial tears Q2H W/A and fortified antibiotic eye drops BID.

Image 4 – Bandage contact lens removed and fluorescein dye instilled. Areas of defect appear healed. Patient reports improved comfort with improved visual acuity.

Image 5 – After 2 minutes, fluorescein was reassessed and tear film distribution has improved stability, increased tear break up time, and only trace punctate staining remains. Patient will continue on artificial tears QID both eyes to maintain corneal health.