Corneal Nerve Assessment by Aesthesiometry: History, Advancements, and Future Directions

Author:

Crabtree Jordan R.1ORCID,Tannir Shadia1,Tran Khoa1,Boente Charline S.2ORCID,Ali Asim34ORCID,Borschel Gregory H.12

Affiliation:

1. Department of Surgery, Indiana University School of Medicine, Indianapolis, IN 46202, USA

2. Department of Ophthalmology, Indiana University School of Medicine, Indianapolis, IN 46202, USA

3. Department of Ophthalmology and Vision Sciences, Hospital for Sick Children, Toronto, ON M5G 1X8, Canada

4. Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, ON M5S 1A1, Canada

Abstract

The measurement of corneal sensation allows clinicians to assess the status of corneal innervation and serves as a crucial indicator of corneal disease and eye health. Many devices are available to assess corneal sensation, including the Cochet–Bonnet aesthesiometer, the Belmonte Aesthesiometer, the Swiss Liquid Jet Aesthesiometer, and the newly introduced Corneal Esthesiometer Brill. Increasing the clinical use of in vivo confocal microscopy and optical coherence tomography will allow for greater insight into the diagnosis, classification, and monitoring of ocular surface diseases such as neurotrophic keratopathy; however, formal esthesiometric measurement remains necessary to assess the functional status of corneal nerves. These aesthesiometers vary widely in their mode of corneal stimulus generation and their relative accessibility, precision, and ease of clinical use. The development of future devices to optimize these characteristics, as well as further comparative studies between device types should enable more accurate and precise diagnosis and treatment of corneal innervation deficits. The purpose of this narrative review is to describe the advancements in the use of aesthesiometers since their introduction to clinical practice, compare currently available devices for assessing corneal innervation and their relative limitations, and discuss how the assessment of corneal innervation is crucial to understanding and treating pathologies of the ocular surface.

Funder

National Institutes of Health, National Center for Advancing Translational Sciences, Clinical and Translational Sciences Award

Publisher

MDPI AG

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