Keratitis: Symptoms, Causes, Treatment

What are the symptoms of keratitis?

Keratitis is an inflammation of the cornea, the clear, dome-shaped surface that covers the front of the eye. Symptoms of keratitis can vary depending on the underlying cause but generally include:

1. Eye redness: Inflammation and irritation can cause the eye to appear red.
2. Eye pain: The pain can range from mild to severe and may feel like a stabbing sensation.
3. Excessive tearing or discharge: Increased tear production or discharge from the eye.
4. Blurred vision: The inflammation can cause the vision to become blurry.
5. Sensitivity to light (photophobia): Discomfort or pain when exposed to bright light.
6. Feeling of something in the eye (foreign body sensation): A gritty or burning sensation.
7. Decreased vision: In more severe cases, vision may be noticeably affected.
8. Eye irritation: Persistent discomfort and itching.

If you suspect keratitis, it is important to seek medical attention promptly, as untreated keratitis can lead to serious complications, including vision loss.

What are the causes of keratitis?

Keratitis can be caused by various factors, including:

1. Infection: Bacterial, viral (such as herpes simplex virus or varicella-zoster virus), fungal, or parasitic infections can lead to infectious keratitis. Contact lens wearers are particularly susceptible to bacterial and fungal infections.
2. Injury or trauma: Any injury to the eye, such as scratches (corneal abrasions), foreign bodies, or chemical burns, can cause keratitis.
3. Dry eye syndrome: Insufficient lubrication of the eye’s surface due to decreased tear production or rapid evaporation can lead to keratitis.
4. Contact lens wear: Improper use, poor hygiene, or extended wear of contact lenses can increase the risk of microbial keratitis.
5. Autoimmune diseases: Conditions like rheumatoid arthritis or conditions that affect the eyelids (such as rosacea) can predispose individuals to keratitis.
6. Allergic reactions: Allergens, such as pollen or pet dander, can cause allergic keratitis.
7. Exposure to ultraviolet (UV) rays: Excessive exposure to UV radiation, such as from sunlight or tanning beds, can cause keratitis (known as photokeratitis).
8. Underlying eye conditions: Conditions like blepharitis (eyelid inflammation) or meibomian gland dysfunction can contribute to keratitis.
9. Malnutrition: Severe vitamin A deficiency can lead to keratitis.

The specific cause of keratitis often determines its treatment and management, so it’s crucial to seek prompt medical attention if you experience symptoms of keratitis.

How is the diagnosis of keratitis made?

Diagnosing keratitis typically involves a thorough eye examination by a healthcare professional, such as an ophthalmologist or optometrist. The diagnosis is based on several steps and considerations:

1. Medical History: The doctor will ask about your symptoms, medical history (including any recent eye injuries or infections), and any relevant risk factors (such as contact lens use or autoimmune conditions).
2. Visual Acuity Test: This test assesses how well you can see at various distances. It helps determine if keratitis has affected your vision.
3. Slit Lamp Examination: This is a specialized microscope with a bright light that allows the doctor to examine the cornea and other structures of the eye in detail. It helps detect signs of inflammation, infection, or damage to the cornea.
4. Fluorescein Staining: A dye called fluorescein is applied to the surface of the eye. This dye highlights any areas of damage or abnormalities on the cornea when viewed under a blue light.
5. Microbial Culture: If infectious keratitis is suspected, samples (such as corneal scrapings) may be taken and sent to a laboratory for microbial culture. This helps identify the specific bacteria, viruses, fungi, or parasites causing the infection.
6. Other Tests: Depending on the suspected cause of keratitis, additional tests may be performed. These could include testing for specific viruses (like herpes simplex virus), blood tests for autoimmune conditions, or imaging tests if there is concern about deeper eye structures.

The combination of these diagnostic methods helps determine the underlying cause of keratitis and guides appropriate treatment. Early diagnosis and treatment are crucial to prevent complications and preserve vision.

What is the treatment for keratitis?

The treatment for keratitis depends on its underlying cause and severity. Here are some general approaches to treatment:

1. Antibiotic, Antiviral, Antifungal, or Antiparasitic Medications: If keratitis is caused by an infection, specific medications targeting the responsible organism (bacteria, virus, fungus, or parasite) will be prescribed. These may be in the form of eye drops, ointments, or oral medications.
2. Corticosteroid Eye Drops: In some cases, corticosteroid eye drops may be prescribed to reduce inflammation and promote healing. However, these are typically used cautiously and only under close supervision due to the risk of worsening infections or other complications.
3. Pain Management: Pain relievers or numbing eye drops may be used to alleviate discomfort.
4. Antibiotic Ointment: For bacterial keratitis, antibiotic ointment may be recommended to apply to the eyelids or around the eye.
5. Antifungal or Antiviral Therapy: For fungal or viral keratitis, specific antifungal or antiviral medications may be required for treatment.
6. Removal of Foreign Bodies: If keratitis is caused by a foreign body, such as a metal shard or dirt, it may need to be carefully removed to prevent further damage.
7. Management of Underlying Conditions: Treating underlying conditions, such as dry eye syndrome or autoimmune diseases, may help manage and prevent recurrent keratitis.
8. Surgery: In severe cases or when other treatments fail, surgery may be necessary. This could involve corneal transplantation (keratoplasty) if there is significant scarring or damage to the cornea.
9. Follow-Up Care: Regular follow-up visits with your eye care provider are essential to monitor your progress and ensure the infection or inflammation is resolving.

It’s crucial to follow your doctor’s recommendations closely and complete the full course of medication as prescribed. Prompt treatment can help prevent complications and preserve vision.