Keratitis: Causes, Symptoms, Diagnosis, Treatment, and Prevention
Inflammation of the cornea, the clear layer covering the front of the eye, causes keratitis. Keratitis can either be infectious or noninfectious, depending on its cause. Keratitis can cause pain, redness, and sensitivity to light and can lead to serious complications. If left untreated, keratitis can lead to corneal scarring, ulcers, or blindness.
Causes of Keratitis
Some of the possible causes of keratitis are:
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Scratches, foreign objects, and chemical burns can damage the cornea and cause inflammation, making it more susceptible to infection by bacteria, viruses, fungi, and parasites.
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Using contact lenses too long, not cleaning them properly, or wearing them while swimming can irritate the cornea. Contact lenses can also trap microorganisms on the surface of the eye and cause keratitis.
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The herpes simplex virus (HSV) and the varicella zoster virus (VZV) can infect the cornea and cause viral keratitis. HSV can cause recurrent episodes of keratitis, while VZV can cause shingles.
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Bacteria such as Staphylococcus, Streptococcus, and Pseudomonas can cause bacterial keratitis, particularly in people who wear contact lenses or have weakened immune systems.
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The presence of fungi, such as Aspergillus, Candida, and Fusarium, can lead to fungal keratitis, especially in people with a history of eye trauma, who use steroid eye drops, or who have chronic eye conditions.
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The parasite Acanthamoeba can cause parasitic keratitis, particularly in people who wear contact lenses and swim in contaminated water. Parasitic keratitis can be very painful and resistant to treatment.
Symptoms of Keratitis
The symptoms of keratitis may vary depending on the type and severity of the infection or inflammation. Some of the common symptoms are:
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Pain: The eye may feel sore, burning, or stabbing. The pain may worsen with blinking or eye movement.
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Redness: The eye may appear red or bloodshot, especially around the iris and pupil.
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Discharge: The eye may produce excess tears, pus, or mucus, which can make the eyelids stick together.
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Blurred vision: The vision may become cloudy, hazy, or distorted, due to the swelling or damage of the cornea.
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Light sensitivity: The eye may become more sensitive to light, causing discomfort or squinting.
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Feeling of something in the eye: The eye may feel like there is a foreign body or a grain of sand in it, causing irritation or scratching.
Diagnosis of Keratitis
The doctor will ask about the patient's history, symptoms, and risk factors for keratitis. He will also examine the eye using a slit lamp, a device that magnifies and illuminates the eye.
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Eye culture: The doctor may take a sample of the fluid or tissue from the eye and send it to a laboratory for testing. This can help identify the type and cause of the infection.
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Eye stain: The doctor may apply a dye, such as fluorescein, to the eye and use a special light to detect any damage or ulceration of the cornea.
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Blood tests: The doctor may order blood tests to check for signs of infection or inflammation, such as white blood cell count, erythrocyte sedimentation rate, or C-reactive protein.
Treatment of Keratitis
The treatment of keratitis depends on the cause, type, and severity of the condition. Some of the possible treatments are:
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If the infection or inflammation persists, a doctor may prescribe eye drops, ointments, or oral medications. The medication may include antibiotics, antivirals, antifungals, or anti-inflammatory drugs. You may need to apply the medication frequently and for a long time.
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If the keratitis is severe or does not respond to medication, the doctor may recommend surgery to remove or replace the damaged cornea. It may involve corneal debridement, which is the removal of dead or infected tissue, or corneal transplantation, which involves replacing the cornea with donor tissue.
Prevention of Keratitis
Some of the ways to prevent or reduce the risk of keratitis are:
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Cleanliness is important for eye hygiene, and you should avoid rubbing or scratching your eyes. Use clean towels and tissues to wipe your eyes, and do not share them with others. Avoid using expired or contaminated eye products, such as eye drops, makeup, or contact lens solutions.
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In order to wear, clean, and store your contact lenses correctly, follow your eye doctor's instructions and recommendations. Don't wear contact lenses for longer than prescribed, and replace them regularly. Make sure to clean your contact lens case daily and do not reuse or top off contact lens solutions. Don't wear contact lenses while sleeping, swimming, or showering. Remove your contact lenses immediately if you experience any signs or symptoms of keratitis.
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Wear sunglasses or goggles to protect your eyes from sunlight, dust, wind, or chemicals. Wear protective eyewear when working with tools, machinery, or hazardous substances. Seek medical attention if you have any eye injuries or foreign objects in your eyes.
