Cotton swab testing would be the most appropriate for which ocular finding?

Cotton swab testing would be the most appropriate for which ocular finding?

• A. Acanthamoeba keratitis
• B. EKC
• C. Exposure keratopathy
• D. Neurotrophic keratopathy

Answer: (D)

The cotton swab (cotton wisp) test is used to assess corneal sensation. This is especially important in neurotrophic keratopathy, where loss or marked reduction of corneal innervation diminishes protective sensation, elevating the risk of persistent epithelial defects and poor healing. By gently touching the cornea with the cotton wisp, you can gauge whether the patient can feel it; decreased or absent sensation supports a diagnosis of neurotrophic keratopathy and guides management to protect the surface and promote healing. In the other conditions listed, sensation testing isn’t the primary diagnostic tool: Acanthamoeba keratitis requires corneal sampling and microbiologic confirmation; epidemic keratoconjunctivitis is diagnosed clinically or by PCR/viral testing; exposure keratopathy relates to eyelid closure and tear film issues, where sensation is typically not the key problem.

The cotton swab (cotton wisp) test is used to assess corneal sensation. This is especially important in neurotrophic keratopathy, where loss or marked reduction of corneal innervation diminishes protective sensation, elevating the risk of persistent epithelial defects and poor healing. By gently touching the cornea with the cotton wisp, you can gauge whether the patient can feel it; decreased or absent sensation supports a diagnosis of neurotrophic keratopathy and guides management to protect the surface and promote healing. In the other conditions listed, sensation testing isn’t the primary diagnostic tool: Acanthamoeba keratitis requires corneal sampling and microbiologic confirmation; epidemic keratoconjunctivitis is diagnosed clinically or by PCR/viral testing; exposure keratopathy relates to eyelid closure and tear film issues, where sensation is typically not the key problem.