Congenital corneal anesthesia.

A 6-year-old boy with a visual acuity of 6/30 (20/100) in each eye had a diffuse corneal epithelial disruption that was most severe in the interpalpebral area. Corneal anesthesia was demonstrated with the Cochet-Bonnet aesthesiometer. Artificial tears, lubricant ointments, and taping of the eyelids were unsuccessful in ameliorating the problem. The use of therapeutic soft contact lenses provided visual acuity of R.E.: 6/12 (20/40), and L.E.: 6/6 (20/20), and arrested the epithelial breakdown. The contact lenses were discontinued after one year, and the corneal epithelium remained intact. Once the cycle of recurrent epithelial breakdown in congenital corneal anesthesia is interrupted for a prolonged period of time, one can expect a continued remission when therapeutic measures are discontinued. With early recognition and treatment of this disorder, corneal scarring can be avoided.