Oxervate (cenegermin) is a prescription eye drop containing recombinant human nerve growth factor (rhNGF) — the first medicine licensed specifically to treat neurotrophic keratitis, a degenerative corneal disease caused by loss of the cornea's nerve supply. Used one drop six times a day for eight weeks, it actively promotes healing of persistent corneal defects. In clinical trials, around two-thirds of patients achieved complete corneal healing. It is a high-cost specialist medicine available on the NHS through specialist commissioning for moderate-to-severe disease, and privately under consultant corneal supervision.
What is neurotrophic keratitis?
The cornea is the most densely innervated tissue in the body, and those nerves do far more than sense touch — they keep the surface healthy, trigger blinking and tear production, and drive natural healing. In neurotrophic keratitis (NK), corneal nerve function is reduced or lost, so the surface breaks down. Even minor damage fails to heal, leading to persistent epithelial defects, ulcers and, in severe cases, corneal melting or perforation.
Common causes include herpes simplex or zoster eye infections, diabetes, previous eye or facial surgery, trigeminal nerve damage, and long-term use of certain eye drops. Because the cornea is numb, NK is often painless despite being serious — which is why specialist assessment of corneal sensation is so important.
Symptoms and signs
- Reduced or absent corneal sensation — the eye feels numb
- Blurred vision from a breaking-down surface
- Redness and a persistent surface defect that won't heal
- Little or no pain despite visible corneal damage
- Recurrent ulcers or, in severe disease, corneal thinning
A corneal ulcer that won't heal? Specialist assessment of corneal sensation confirms neurotrophic keratitis and whether Oxervate is appropriate.
Book a corneal assessmentTreatment options for neurotrophic keratitis
Treatment is staged according to severity. Oxervate is the key disease-modifying option for moderate-to-severe NK; surface-protection measures support healing at every stage.
Many patients with NK also have an unstable tear film. We treat coexisting dry eye and lid disease alongside Oxervate — for example with dry eye IPL, Miebo drops or, where blepharitis is a factor, Xdemvy.
How the Oxervate course works
Oxervate is not surgery — it is a carefully supervised course of eye drops. Because it is a delicate biologic, it is supplied as a weekly multidose kit kept refrigerated and brought to room temperature before use.
- Confirm the diagnosis — your consultant measures corneal sensation and grades the disease to confirm Oxervate is appropriate.
- Pause any toxic drops — preservative-laden or unnecessary medications that harm the surface are stopped first.
- Use one drop six times a day, roughly two hours apart, in the affected eye(s) for the full eight weeks. Wait at least 15 minutes before any other drop.
- Attend monitoring reviews so healing can be tracked and the surface protected throughout.
- Complete the full course — stopping early reduces the chance of complete healing.
Healing timeline
The cornea heals progressively over the treatment course. Most of the benefit is seen by the end of the eight weeks, and healing is often durable.
Weeks 1–2
Treatment begins. Mild eye pain, watering or redness can occur as nerves respond — a sign the drops are active. Surface protection continues.
Weeks 3–6
The persistent defect begins to close. Reviews track the shrinking surface area and overall corneal health.
Week 8
End of the course. In trials around two-thirds of patients achieved complete healing of the corneal defect.
Beyond the course
Healing is often maintained. Ongoing lubrication and lid care protect the surface; a second course is occasionally considered if needed.
Cost & access
Oxervate is a high-cost specialist medicine. We are transparent about how it is funded so you can plan with confidence.
- NHS specialist commissioning: Oxervate is recommended for moderate-to-severe neurotrophic keratitis and is funded through specialist NHS services for eligible patients. We can assess you and advise on, or support, this pathway.
- Private consultation: from £250 for a consultant corneal assessment including sensation and surface testing.
- Private medication: the eight-week course is a high-cost biologic supplied as weekly kits and is quoted individually — it runs to several thousand pounds per week of treatment, so most patients are guided toward the NHS specialist route where eligible.
- Insurance: coverage varies by policy; we will help you check eligibility before you commit.