Corneal neurotization is a procedure used to treat loss of sensation in the cornea — the clear outer layer of the eyeball. 

The procedure can:

  • Help kids regain feeling in their eyes
  • Prevent eye damage and loss of vision
  • Help reverse neurotrophic keratitis, a corneal disease that often develops after a person loses sensation in their cornea

The Facial Nerve Institute at St. Louis Children’s Hospital is one of only a few places in the United States to offer it.

Reasons for Corneal Neurotization in Kids

Loss of feeling in the cornea (also called corneal anesthesia) is usually the result of damage to the nerve that is responsible for the eye’s sensation. 

This same nerve is also responsible for certain face movements, so corneal anesthesia often happens alongside facial paralysis. It usually only happens in one eye, but it can happen in both. 

Corneal neurotization is most often used to regenerate nerves damaged because of:

  • Brain tumors
  • Traumatic head injury
  • Congenital anomaly (a problem present since birth)
  • Eye infection
  • Previous eye surgery

The procedure can help kids regain feeling in their eyes. It can also prevent or reverse neurotrophic keratitis (a disease in which the cornea breaks down, leading to pain and loss of vision). 

Without treatment, kids with corneal anesthesia are likely to develop neurotrophic keratitis. And kids who already have neurotrophic keratitis are likely to experience worsening symptoms.

Is Corneal Neurotization Right for Your Child?

If your child’s eyes feel numb — with or without facial paralysis — they may be a candidate for corneal neurotization.

At the Facial Nerve Institute, our team can conduct an expert evaluation to determine whether the procedure is right for your child.

What Happens During Corneal Neurotization 

During corneal neurotization, an ophthalmologist and a plastic surgeon work together to insert a healthy nerve from a deceased donor into your child’s eye, usually through a small incision. (Your child will be under general anesthesia.)

This type of procedure is called a nerve graft. Once the new nerve is inserted, it will take several months to regenerate the connections that give the eye feeling.

What to Expect After Corneal Neurotization

Your care team will provide you with complete instructions — based on your child’s individual case — about what to do after surgery.

In general, here’s what you can expect:

  • Your child will be able to go home after one night in the hospital.
  • Their eye will be held closed with sutures to promote healing and prevent infection. We can remove the sutures after about a week.
  • Your child will use medicated eye drops to promote healing for a few weeks after surgery.
  • Your child will regain sensation in their eye after the nerve has regenerated. All of our patients have regained at least some sensation in their eye, and many of our patients have regained full sensation.

Why Choose St. Louis Children’s for Corneal Neurotization

A team devoted to facial nerve injuries: The Facial Nerve Institute at St. Louis Children’s Hospital is home to a team of experts who work together to treat nerve injuries affecting the face and eyes. If your child needs treatment for facial paralysis in addition to corneal neurotization, our team can develop a plan that accounts for additional treatments your child has had or will need.

Specialists focused on kids: Our pediatric plastic surgeons, pediatric anesthesiologists and pediatric ophthalmologists focus primarily on treating children and adolescents. Their in-depth understanding of children’s and teens’ anatomy allows them to tailor surgical plans to your child’s needs.

Expert surgeons: Plastic surgeons and ophthalmologists at St. Louis Children’s Hospital helped pioneer corneal neurotization. Every child they’ve operated on has regained some feeling in their eye. Many have regained all feeling in their eye.