New developments in the management of persistent corneal epithelial defects.

Persistent epithelial defect (PED) is a corneal epithelial defect that failed to heal after 2 weeks. It is a condition that carries much morbidity, and our understanding of PED remains poor, with current treatment methods often having unsatisfactory outcomes. With PED becoming more prevalent, more efforts are required to establish reliable treatment modalities. Our reviews describe the causes of PED and the different approaches developed to manage them, as well as their associated limitations. Emphasis is placed on understanding various advances in the development of new treatment modalities. We have also described a case a woman with a background of graft-versus-host disease (GVHD) on long-term topical corticosteroids who developed complicated PED involving both eyes. The current approach to managing PED generally involves exclusion of an active infection, followed by treatment modalities that aim to encourage corneal epithelial healing. Success rates, however, remain far from desirable, as treatment remains challenging due to multiple underlying etiologies. In summary, advances in the development of new therapies may be able to facilitate progress in the understanding and treatment of PED.