Congenital Corneal Anaesthesia: A Case Report With Confocal Microscopy

Congenital corneal anaesthesia is a rare condition that is characterised by the absence of corneal sensation. It can occur in isolation or be associated with somatic malformations or neurological disorders.

Moorfields Eye Hospital

We report the case of a 35-year-old female, who was referred for unilateral loss of corneal sensation.

The patient was asymptomatic and her examination showed unilateral corneal punctate epithelial erosions with complete absence of corneal sensation. After ruling out neurological disorders with a normal MRI, we performed in vivo confocal microscopy, which provided real-time imaging of the corneal neural architecture. This showed a complete lack of subepithelial nerve plexus, correlating with the clinical findings.

This case highlights the effectiveness of confocal microscopy in diagnosing corneal anaesthesia, with early diagnosis and treatment helpful in avoiding long-term sequelae associated with neurotrophic keratopathy.