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Keratitis – Corneal Inflammation: Causes & Treatment

Keratitis is an inflammation of the cornea, the clear front surface of the eye. It can result from infections, injuries, or dry eyes, and requires prompt medical attention.

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Things worth knowing about "Keratitis"

Keratitis is an inflammation of the cornea, the clear front surface of the eye. It can result from infections, injuries, or dry eyes, and requires prompt medical attention.

What is Keratitis?

Keratitis is an inflammation of the cornea, the transparent, dome-shaped tissue that covers the front of the eye. The cornea plays a vital role in focusing vision, and any damage or inflammation can significantly impair eyesight. Keratitis can develop rapidly and affects people of all ages. Without timely treatment, it can lead to permanent vision loss.

Causes

Keratitis can be triggered by a variety of factors:

Infectious causes: Bacteria (e.g., Staphylococcus aureus, Pseudomonas aeruginosa), viruses (e.g., herpes simplex virus), fungi, or parasites (e.g., Acanthamoeba) can infect the corneal tissue.
Non-infectious causes: Corneal injuries, prolonged contact lens wear, intense UV radiation (e.g., snow blindness), dry eye syndrome, or autoimmune disorders.
Contact lens wearers face a higher risk, as improper handling or extended wear can create conditions favorable to infection.

Symptoms

Common signs and symptoms of keratitis include:

Severe eye pain and a sensation of something in the eye
Redness of the eye
Light sensitivity (photophobia)
Tearing and eye discharge
Blurred vision or decreased visual acuity
Swelling of the eyelids

Diagnosis

Diagnosis of keratitis is performed by an ophthalmologist using the following methods:

Slit-lamp examination: A specialized microscope allows detailed evaluation of the cornea and surrounding structures.
Corneal swab and culture: In suspected infectious keratitis, a sample is taken to identify the causative organism.
Fluorescein staining: A dye highlights corneal defects under blue light illumination.
Confocal microscopy: High-resolution imaging used to detect fungal or parasitic infections.

Treatment

Treatment depends on the underlying cause of keratitis:

Infectious Keratitis

Bacterial: Antibiotic eye drops or ointments (e.g., ciprofloxacin, moxifloxacin).
Viral: Antiviral medications such as aciclovir, available as eye drops or in systemic form.
Fungal: Antifungal eye drops (e.g., natamycin, voriconazole).
Acanthamoeba: Combination therapy with antiseptic eye drops, often required for several months.

Non-Infectious Keratitis

Treatment of the underlying cause (e.g., artificial tears for dry eye, UV-protective eyewear for snow blindness).
Corticosteroid eye drops may be used to reduce inflammation in selected cases, but only under strict medical supervision.

Severe Cases

In cases of significant corneal scarring, a corneal transplant (keratoplasty) may be necessary to restore vision.

When to See a Doctor

Any sudden eye pain, decreased vision, light sensitivity, or eye redness should be evaluated by an ophthalmologist immediately. Keratitis is a medical emergency that can lead to blindness if left untreated.

References

Kanski, J.J. & Bowling, B. (2016). Clinical Ophthalmology: A Systematic Approach. Elsevier.
World Health Organization (WHO). Priority eye diseases: Corneal opacities. Available at: https://www.who.int/blindness/causes/priority/en/index8.html
Dart, J.K.G. et al. (2008). Risk factors for microbial keratitis with contemporary contact lenses. Ophthalmology, 115(10), 1647–1654. PubMed PMID: 18597850.

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