Neurotrophic keratopathy is a corneal disease characterized by impaired corneal innervation. It can lead to corneal epithelial defects, ulcerations, and perforations. Topical insulin has been shown to be effective in treating this disorder. Insulin is a growth factor that can promote corneal epithelial cell proliferation and migration. In addition, it can also inhibit corneal epithelial cell apoptosis. Topical insulin has previously been found to enhance corneal wound healing. This article reviews the current understanding of the mechanism of action of topical insulin in the treatment of neurotrophic keratopathy.

Introduction: Odontogenic infections may influence distant structures, including the eye. Their extension into the paranasal sinuses and orbital region can contribute to inflammatory and glaucomatous conditions. Case Report: A 46-year-old man was examined for a possible odontogenic source of chronic eye disease. The patient had an 18-year history of progressive vision loss in his left eye associated with Posner–Schlossmann syndrome, chronic uveitis, and episodic elevation of intraocular pressure (IOP). Imaging studies revealed the presence of a foreign body in the alveolar recess of the left maxillary sinus, as detected on panoramic radiography, cone-beam computed tomography (CBCT), and infrared thermography (IRT). Preliminary IRT examination showed marked thermal asymmetry (ΔT = 1.1 °C) between the left and right sides of the maxilla. Worsening of ocular symptoms and increased IOP despite steroid treatment prompted surgical treatment. The foreign body, identified as a root canal filling, was removed, and the chronically inflamed sinus mucosa was excised. During a follow-up visit two weeks later, the IRT examination showed a reduction in temperature difference (ΔT = 0.2 °C) and routine postoperative healing. After two months, no thermal asymmetry was found (ΔT = 0 °C), and an ophthalmological examination showed no active inflammation. Six months after the procedure, the patient remained asymptomatic, and the IRT examination revealed only minimal residual variability within the measurement tolerance (ΔT = 0.1 °C), consistent with the resolution of the sinus inflammation. Conclusions: This case highlights the value of interdisciplinary diagnostics in identifying odontogenic contributors to chronic ocular disease. Infrared thermography proved to be a helpful non-invasive adjunct for detecting and monitoring subclinical maxillary sinus inflammation.