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Abstract

Purpose
To emphasize that filamentary keratopathy can occur in the long-term care of patients in a vegetative state.

Methods
Clinical observation of 2 young patients who had survived respectively 16 and 81/2 years in a vegetative state after an acute traumatic brain accident. Interventions were analyzed against the background of the various speculations on the relationship between filamentary keratopathy and the vegetative state.

Results
The medical records of both patients recorded 36 and 24 episodes of "a red eye", respectively, which in most cases were due to filamentary keratopathy. The episodes lasted 1-51/2 months, despite lubrication, removal of filaments and regular application of corticoid ointment. The longest remission occurred when the eyes were opened frequently and no topical medication was applied. This experience supports the hypothesis that prolonged eyelid closure in these patients is more likely to be related to filamentary keratopathy than to a fluid disturbance.

Conclusions
Filamentary keratopathy can be a chronic problem in the long-term course of a patient in a vegetative state with remissions and exacerbations. These cases support a link, although the exact mechanism is speculative. The incidence and effective treatment await further reports.

Keywords
Filamentary Keratopathy, Vegetative State, Long-Term Care, Nursing Home