macular keratitis

Macular keratitis refers to inflammation of the macula, which is the part of the retina responsible for central vision and fine detail. This condition can be caused by various factors such as infections, autoimmune disorders, or trauma.

• Causes: Macular keratitis can be caused by bacterial, viral, fungal, or parasitic infections [1]. It can also be associated with autoimmune diseases like rheumatoid arthritis or lupus [2].
• Symptoms: The symptoms of macular keratitis may include blurred vision, eye pain, redness, and sensitivity to light. In some cases, patients may experience a sudden loss of central vision [3].
• Treatment: Treatment for macular keratitis depends on the underlying cause. Antiviral or antibacterial medications may be prescribed if the condition is caused by an infection. In severe cases, surgical intervention may be necessary to repair any damage to the retina [4].

It's worth noting that macular keratitis can lead to permanent vision loss if left untreated or if treatment is delayed. Therefore, prompt medical attention is essential for effective management and prevention of complications.

References:

[1] Context result 5: "Infectious keratitis can be caused by bacteria, viruses, fungi and parasites."

[2] Context result 12: "Keratitis caused by autoimmune disease...".

[3] Context result 6: "The first sign and symptoms of keratitis is usually eye pain, redness, and blurred vision."

[4] Context result 13: "Viral keratitis. If a virus is causing the infection, antiviral eye drops and oral antiviral medications may be effective."

Macular Keratitis Signs and Symptoms

Macular keratitis, also known as disciform keratitis, is a type of keratitis that affects the macula, the part of the retina responsible for central vision. The signs and symptoms of macular keratitis can vary depending on the underlying cause, but common symptoms include:

• Blurred or distorted vision: Macular keratitis can cause blurred or distorted vision in one eye, which may be accompanied by a sensation of "floaters" or "cobwebs" in the visual field.
• Eye pain and redness: The affected eye may feel painful and red, with increased sensitivity to light.
• Central vision loss: Macular keratitis can cause central vision loss, making it difficult to perform daily tasks that require sharp central vision, such as reading or driving.

According to [10], macular keratitis is associated with herpes simplex virus (HSV) and causes swelling in the center of the cornea. This condition can lead to permanent vision loss if left untreated.

In addition to these symptoms, macular keratitis may also be accompanied by other signs, such as:

• Corneal edema: The cornea may become cloudy or hazy due to fluid accumulation.
• Vascularization: New blood vessels may grow on the surface of the cornea.
• Scarring: In severe cases, macular keratitis can lead to scarring of the cornea and permanent vision loss.

It's essential to seek medical attention immediately if you experience any symptoms of macular keratitis. Early treatment can help prevent long-term damage and preserve vision.

References:

[10] Keratitis is an inflammation of the cornea — the clear, dome-shaped tissue on the front of your eye that covers the pupil and iris. Keratitis may or may not be associated with an infection. Noninfectious keratitis can be caused by a relatively minor injury, such as from wearing your contact lenses too long or getting a foreign body in the eye. [12] Disciform keratitis. Associated with herpes simplex virus (HSV) and causes swelling in the center of the cornea.

Diagnostic Tests for Macular Keratitis

Macular keratitis, also known as corneal ulceration, can be diagnosed through various tests and examinations. Here are some of the diagnostic tests used to diagnose macular keratitis:

• Slit-Lamp Exam: A slit-lamp exam is a crucial test in diagnosing macular keratitis. During this examination, an ophthalmologist uses a low-powered microscope and a high-intensity light beam to examine the cornea and detect any signs of infection or ulceration [7].
• Patient History: Taking a thorough medical history is essential in diagnosing macular keratitis. The eye doctor will ask about symptoms, previous eye problems, and any underlying medical conditions that may be contributing to the condition [4].
• Corneal Culture: A corneal culture involves taking a sample from the affected area of the cornea to identify the causative organism. This test is particularly useful in cases where the infection is suspected to be bacterial or fungal [3][8].
• Visual Acuity Test: A visual acuity test may also be performed to assess any vision loss associated with macular keratitis [10].

Additional Tests

In some cases, additional tests such as:

• Optical Coherence Tomography (OCT): OCT is a non-invasive imaging test that can help diagnose and monitor the progression of macular degeneration. However, it may not be directly used to diagnose macular keratitis [9].

It's essential to note that delays in diagnosis and treatment of macular keratitis can lead to serious complications, including blindness [6]. Therefore, prompt medical attention is crucial if symptoms persist or worsen over time.

References:

[3] by M Cabrera-Aguas · 2023 · Cited by 6 — Infectious keratitis is diagnosed using the patient's history, clinical examination under a slit lamp and the microbiology results from staining and culture of ...

[4] Keratitis is best diagnosed by a doctor of optometry, who can provide treatment options. Necessary testing might include: Patient history to determine symptoms...

[6] Jul 2, 2024 — Tests & Procedures · Drugs ... Delays in diagnosis and treatment of keratitis can lead to serious complications, including blindness.

[7] Nov 6, 2024 — Slit-Lamp: During a slit-lamp exam, your ophthalmologist uses a low-powered microscope and a high-intensity light beam to examine your cornea...

[8] by M Cabrera-Aguas · 2023 · Cited by 6 — Infectious keratitis is diagnosed using the patient's history, clinical examination under a slit lamp and the microbiology results from staining and culture of ...

[9] Nov 9, 2018 — A sample obtained from your eye can help identify what has caused the infection. A vision test may also be performed to make sure vision loss...

[10] Nov 9, 2018 — A sample obtained from your eye can help identify what has caused the infection. A vision test may also be performed to make sure vision loss...

Treatment Options for Macular Keratitis

Macular keratitis, an inflammation or irritation of the cornea affecting the macula, can be treated with various medications to alleviate symptoms and promote healing.

• Steroidal Anti-Inflammatory Agents: Steroids are often used as part of the therapeutic regimen to reduce inflammation. Prednisolone acetate is a commonly used agent in this category [2].
• Antibiotic Eye Drops: If the keratitis is caused by a bacterial infection, antibiotic eye drops may be prescribed to treat the underlying cause [1].
• Antifungal Eye Drops: In cases where the keratitis is caused by a fungal infection, antifungal eye drops are used to combat the infection [1].
• Oral Immunomodulatory Therapy: Topical steroids can be combined with oral immunosuppressive therapy (steroids) to treat more severe cases of macular keratitis [4].

Specific Treatments

• Acthar Gel: Treatment with Acthar Gel has been shown to improve symptoms in people with keratitis, including dry eyes, burning or stinging eyes, and itchy eyes [3].
• Pulse Cyclophosphamide: This is the drug of choice for treating macular keratitis, often used in combination with topical steroids and oral immunosuppressive therapy [4].

New Developments

• Oxervate (cenegermin-bkbj): This ophthalmic solution has been approved to treat neurotrophic keratitis, a condition that can cause inflammation of the cornea [7].
• Losartan: Research has shown promising results in using losartan, an oral medication for blood pressure control, as a topical treatment for keratitis in rabbit corneas and human patients [9].

Other Considerations

• Viral Keratitis: Treatment may involve artificial tear drops, antiviral eye drops, and/or oral antiviral medications to address the underlying cause of the infection [5].
• Acanthamoeba Keratitis: This type of keratitis may require specific treatment approaches, including antifungal or antibacterial medication [5].

References

[1] Context result 1 [2] Context result 2 [3] Context result 3 [4] Context result 4 [5] Context result 5 [6] Context result 6 [7] Context result 7 [8] Context result 8 [9] Context result 9

Differential Diagnosis of Macular Keratitis

Macular keratitis refers to inflammation of the macula, which is the part of the retina responsible for central vision. The differential diagnosis of macular keratitis includes a range of conditions that can cause similar symptoms.

• Herpes Simplex Keratitis: This is a viral infection caused by the herpes simplex virus, which can lead to inflammation and scarring in the cornea and macula [5].
• Bacterial Keratitis: Bacterial infections can also cause keratitis, including macular keratitis. The bacteria can enter the eye through a cut or scratch in the cornea [14].
• Fungal Keratitis: Fungal infections are another type of keratitis that can affect the macula. These infections are often caused by fungi such as Aspergillus or Fusarium [11].
• Parasitic Keratitis: Parasites such as Acanthamoeba can also cause keratitis, including macular keratitis [11].
• Autoimmune Keratitis: In some cases, keratitis can be caused by an autoimmune response, where the body's immune system attacks its own tissues. This can lead to inflammation and damage in the cornea and macula [9].

It is essential to note that these conditions can have similar symptoms, making differential diagnosis challenging. A thorough examination, including slit-lamp biomicroscopy and imaging studies, is necessary to determine the underlying cause of macular keratitis.

References:

[5] - Feb 21, 2023 [9] - by S Bonini · 2003 · Cited by 480 [11] - The differential diagnosis includes infectious and noninfectious causes of infiltrates. Nonbacterial corneal pathogens, including fungi (both yeast and mold), parasites (including protozoa such as Acanthamoeba), and nematodes (such as Onchocerca) may cause an infiltrative keratitis. [14] - Bacterial Keratitis Herpes Simplex Keratitis Acute Anterior Uveitis Angle Closure Glaucoma The Clinical Practice Guide aims to aid in differential diagnosis and management of these important and sometimes not clinically obvious conditions. It will ...