Keratitis

Choose the content to read

• What is keratitis?
• What causes keratitis?
• What are the symptoms of keratitis?
• What are the risk factors that may cause keratitis?
• How is keratitis diagnosed?
• How is keratitis treated?
• What is the prevention of keratitis?
• A note from MedPark’s doctor

What is keratitis?

Keratitis is an inflammation of the cornea. It can occur with or without an infection. 
Bacteria, viruses, fungi, or parasites can cause infectious keratitis.

Noninfectious keratitis may result from minor injuries such as prolonged wearing of contact lenses or foreign objects entering the eye. Occasionally, keratitis develops in patients with systemic autoimmune diseases such as rheumatoid arthritis.

What causes keratitis?

Causes of infectious keratitis

• Bacteria are the most common cause.
• Viruses such as shingles or herpes simplex. Herpes simplex keratitis tends to recur
• Fungi
• Parasites such as amoeba can cause acanthamoeba keratitis. It is a common cause for people who wear contact lenses while swimming.

Causes of noninfectious keratitis

• Eye injury from surgery, accident, or eyelashes scraping the eye surface. 
• Prolonged use of contact lenses.
• Foreign object in the eye.
• Excessive UV ray exposure.
• Eyelid disorders such as entropion or autoimmune disorders that cause dry eye, such as Sjogren's syndrome and rheumatoid arthritis, with accompanied dry eyes, leading to corneal inflammation.
• Vitamin A deficiency.

What are the symptoms of keratitis?

• Redness and pain in the eye
• Watery eyes or eye discharge
• Difficulty opening the eyelid due to irritation or pain.
• Blurry or reduced vision
• Light sensitivity 
• A sensation of a foreign object in the eye

When should I see a doctor if I have keratitis?

It is crucial to schedule an appointment with an ophthalmologist if you experience the abovementioned symptoms. Timely intervention often enables successful treatment. Keratitis, especially from a severe infection, can result in significant complications that could permanently damage vision, if treatment is not immediate.

What are the risk factors that may cause keratitis?

• Extended contact lens wear leads to eye damage and increased susceptibility to infection.
• Inadequate cleaning or disinfection of contact lenses.
• Wearing lenses while immersed in pools, bathtubs, or outdoor water sources. 
• Long-term use of corticosteroids. 
• Weakened immune system.
• Dry eyes. 
• Eye injuries, including those from surgery.

How is keratitis diagnosed?

• A thorough eye examination with a slit-lamp exam and potential use of fluorescein dye to enhance the visibility of corneal abnormalities
• Laboratory analysis: Tears or corneal cells may be collected and sent to a lab for proper analysis.

How is keratitis treated?

Infectious keratitis

• Bacterial keratitis: The primary treatment for bacterial keratitis involves antibiotic eye drops. The frequency of these drops varies depending on the severity of the infection, ranging from four times a day to every 30 minutes, including nighttime administration. In some cases, oral antibiotics may be prescribed as adjunct therapy. 
• Fungal keratitis: Treatment for fungal keratitis typically involves antifungal eye drops and oral antifungal medication.
• Viral keratitis: Antiviral eye drops and oral antiviral medications are effective treatments for viral keratitis caused by certain viruses. Artificial tear drops can also relieve the symptoms. 
• Acanthamoeba keratitis: Treatment for keratitis caused by the parasite acanthamoeba involves the application of antiparasitic eye drops. However, some acanthamoeba infections are resistant to medications, necessitating prolonged treatment lasting several months. Severe cases may require a cornea transplant.
  If keratitis fails to respond to medication or results in permanent corneal damage that significantly affects vision, your ophthalmologist may recommend a corneal transplant.

Noninfectious keratitis

How the condition is treated depends on its severity and causes. Artificial tear drops are usually sufficient for mild discomfort. If there is significant tearing and pain, an ophthalmologist might recommend topical eye drops.

When will my condition improve?

You may start to feel improvement within one or two days of beginning medication. Nonetheless, healing may require more time for severe cases.

What are the complications of keratitis?

• Persistent corneal inflammation and scarring
• Chronic and recurrent viral infections of the cornea
• Temporary or permanent vision impairment
• Permanent vision loss

What is the prevention of keratitis?

Caring for your contact lenses is essential in preventing keratitis.

• Remove contact lenses before sleeping.
• Thoroughly wash, rinse, and dry your hands before handling your contact lenses.
• Follow the instructions on how to take care of your contact lenses.
• Use sterile products specifically designed for your lens type.
• Replace your contact lenses according to the recommended schedule.
• Renew your contact lens case every 3 to 6 months.
• Discard the solution in the contact lens case every time you disinfect your lenses; refrain from mixing a new solution with the old one.
• Avoid wearing contact lenses while swimming.

Preventing the transmission of viral keratitis

While some forms of viral keratitis may not be entirely preventable, the following measures can help manage occurrences.

• Refrain from touching your eyes, eyelids, and the surrounding skin if you have a cold sore or herpes blister unless you have thoroughly washed your hands.
• Use only eye drops prescribed by an ophthalmologist.
• Frequent hand washing can help reduce viral outbreaks.

Preparation before physician appointment

Make a physician appointment when you have eye symptoms that worry you. Before seeing your doctor, you should stop wearing contact lenses or applying eye drops. Write down your symptoms, medications, and dietary supplements you have been taking, and questions you would like to ask your doctor.

Samples of questions are:

• What causes my symptoms? 
• Do I have to undergo any tests?
• What kind of treatment do you recommend? Are there any other alternatives?
• When will my symptoms improve?

You should be ready to respond to questions as follows:  

• When did you start to develop eye symptoms? 
• Are both eyes affected?
• What can improve or worsen your symptoms?
• Have you had eye injuries recently?
• Do you wear contact lenses?
• Have you been wearing contact lenses while swimming?
• What is your usual contact lens care routine?
• Have you been taking medications or dietary supplements?
• Have you recently switched the type of cosmetics?

FAQ

• What are the differences between uveitis and keratitis?
  The primary distinction between uveitis and keratitis lies in the location of the inflammation within the eye. While their signs and symptoms may overlap, uveitis specifically targets the uvea.
  
  The uvea encompasses the iris, choroid, and ciliary body. In contrast, keratitis affects the cornea, serving as the protective layer covering the iris.
  
  Pink eyes also show similar symptoms of eye redness as the conjunctiva is affected. When inflammation affects the cornea and conjunctiva, it is known as keratoconjunctivitis.

A note from MedPark’s doctor

Like any eye condition, early treatment for keratitis is crucial. Contact your doctor for a proper diagnosis and prompt and accurate treatment if you experience eye pain with redness, swelling, difficulty opening the eye, or blurred vision.