Exposure keratopathy (also known as exposure keratitis) is medical condition affecting the cornea of eyes. It can lead to corneal ulceration and permanent loss of vision due to corneal opacity. Normally, corneal surface is kept moist by blinking. during sleep, it is covered by lids. Increased corneal exposure to the air due to incomplete or inadequate eyelid closure cause increased evaporation of tear from corneal surface. Increased evaporation of tear cause instability of the tear film  and dryness of corneal surface. This will lead to corneal epithelial damage. Both tear film and corneal epithelium play significant role in corneal protective mechanism. The dryness and epithelial damage will allow micro organism to penetrate cornea and thus keratitis occurs. Signs and symptoms
Symptoms are similar to dry eye. Patients may complain redness, irritation, ocular discomfort, burning, and foreign body sensation. Punctate epithelial defects, epithelial break down and stromal melting may be seen in corneal examination. Corneal ulceration may develop due to bacterial invasion. Complications
Main complication of exposure keratopathy is permanent vision loss due to corneal opacification. Stromal melting may occasionally lead to corneal perforation. Causes
Exposure keratopathy may occur due to mechanical eyelid abnormalities or neuro-paralytic corneal anesthesia. It may occur secondary to ocular surgeries like blepharoplasty, ptosis surgery etc. also. Lagophthalmos
Lagophthalmos, the inability to close the eyelids completely is the main cause of exposure keratopathy. Common cause of lagophthalmos is facial nerve (CN VII) palsy. Facial nerve function may affect in several conditions like cerebrovascular accident, head trauma, brain tumors, Bells palsy etc.
Another treatment option for amphetamine dependence is aversion therapy based on classical conditioning module; this will combine the amphetamine with a negative thing or opposite stimulus. Treatment for amphetamines is growing at extremely high rates around the world. Psychostimulants that increase dopamine and mimic the effects of substituted amphetamines, but with lower abuse liability, could theoretically be used as replacement therapy in amphetamine dependence. However, the few studies that used amphetamine, bupropion, methylphenidate, and modafinil as a replacement therapy did not result in less methamphetamine use or craving. References
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