sclerosing keratitis

Sclerosing Keratitis: A Progressive Corneal Inflammation

Sclerosing keratitis is a type of corneal inflammation characterized by progressive opacification of the cornea, which typically begins in an inferior arc from nasal to temporal aspects and extends to include all the lower cornea [13]. This condition is often associated with scleritis, an inflammation of the sclera, and can be caused by various factors such as infections, autoimmune responses, or trauma.

Key Features:

• Progressive opacification of the cornea
• Typically begins in an inferior arc from nasal to temporal aspects
• Extends to include all the lower cornea
• Associated with scleritis, an inflammation of the sclera
• Can be caused by infections, autoimmune responses, or trauma

Causes and Risk Factors:

• Infections, such as microbial keratitis
• Autoimmune responses, such as in patients with rheumatoid arthritis (RA)
• Trauma to the eye, including corneal injuries or foreign bodies
• Contact lens wear, which can cause corneal irritation and inflammation

Symptoms and Diagnosis:

• Symptoms may include blurred vision, eye pain, redness, and sensitivity to light
• Diagnosis is typically made through a careful history, slit-lamp examination, and corneal scraping cultures
• Keratitis is an ocular emergency and requires prompt medical attention to prevent permanent vision loss [14]

Treatment and Prognosis:

• Treatment depends on the underlying cause of the keratitis and may include antibiotics, anti-inflammatory medications, or surgery
• Prompt treatment can help prevent permanent vision loss and improve outcomes
• However, sclerosing keratitis can still lead to significant visual impairment if left untreated or inadequately managed.

Sclerosing Keratitis Signs and Symptoms

Sclerosing keratitis, a chronic condition affecting the cornea, presents with distinct signs and symptoms. The following are key indicators:

• Corneal Opacification: A white or grayish-yellow area of opacified cornea, which may be more evident with fluorescein staining [2].
• Vascularization: An area of vascularized cornea, indicating inflammation and potential damage to the eye.
• Pain and Redness: While not exclusive to sclerosing keratitis, pain and redness are common symptoms associated with this condition [1].

Additional Symptoms

• Blurred Vision: Inflammation of the cornea can cause blurred or cloudy vision, affecting the patient's ability to see clearly.
• Eye Swelling: In some cases, the affected eye may swell shut due to severe inflammation.

It is essential to note that sclerosing keratitis can be a manifestation of underlying conditions, such as scleritis. A comprehensive diagnosis by an eye care professional is necessary to determine the cause and extent of the condition [5].

References

[1] This condition is known as keratitis. Depending on the cause, keratitis symptoms may vary, but pain and redness are key indicators. [2] Sclerosing keratitis is a chronic process marked by an area of opacified and vascularized cornea that progresses toward the visual axis. [5] by J Hung — Scleritis presents with a characteristic violet-bluish hue with scleral edema and dilatation.

Sclerosing keratitis, also known as sclerokeratitis, is a rare and serious eye condition that can cause inflammation in the cornea and sclera. Diagnosing this condition requires a combination of clinical evaluation and laboratory tests.

Clinical Evaluation

The diagnosis of sclerosing keratitis is primarily based on clinical evaluation by an ophthalmologist or optometrist. The symptoms of sclerosing keratitis may include:

• Eye pain
• Redness
• Swelling
• Corneal edema (swelling)
• Infiltration of inflammatory cells in the cornea

Laboratory Tests

While laboratory tests are not always necessary for diagnosing sclerosing keratitis, they can be helpful in confirming the diagnosis and identifying any underlying conditions. Some common laboratory tests used to diagnose sclerosing keratitis include:

• C-ANCA test: This is a serological marker that can help confirm the diagnosis of sclerosing keratitis.
• Corneal scraping cultures: These are used to identify any infectious agents that may be causing the inflammation in the cornea.
• Slit-lamp examination: This is a non-invasive test that allows the ophthalmologist or optometrist to examine the cornea and sclera for signs of inflammation.

Other Diagnostic Tests

In some cases, other diagnostic tests may be necessary to rule out other conditions that can cause similar symptoms. These may include:

• Imaging studies: Such as ultrasound or MRI scans to evaluate the extent of the inflammation in the cornea and sclera.
• Blood tests: To check for any underlying systemic conditions that may be contributing to the development of sclerosing keratitis.

References

• [1] Sclerokeratitis is a rare condition that can cause inflammation in the cornea and sclera. (Search result 2)
• The diagnosis of sclerosing keratitis is primarily based on clinical evaluation by an ophthalmologist or optometrist. (Search result 8)
• C-ANCA is a serological marker that can help confirm the diagnosis of sclerosing keratitis. (Search result 1)
• Corneal scraping cultures are used to identify any infectious agents that may be causing the inflammation in the cornea. (Search result 11)

Sclerosing keratitis, also known as scleromalacia perforans, is a rare and chronic inflammatory condition affecting the cornea and sclera. While there are no specific treatments for sclerosing keratitis, various medications may be used to manage symptoms and slow disease progression.

Anti-inflammatory medications: Corticosteroids, such as prednisone or dexamethasone, may be prescribed to reduce inflammation and swelling in the affected area [9]. However, long-term use of corticosteroids can have adverse effects, including cataract formation and glaucoma [10].

Immunosuppressive medications: In some cases, immunosuppressive agents like cyclosporine or azathioprine may be used to reduce inflammation and prevent further damage to the cornea and sclera [11].

Microfilaricidal drugs: For patients with sclerosing keratitis caused by onchocerciasis (river blindness), microfilaricidal drugs such as ivermectin or albendazole may be used to eliminate the parasitic infection [8].

It is essential to note that treatment for sclerosing keratitis often involves a multidisciplinary approach, including ophthalmology, dermatology, and infectious disease specialists. The primary goal of treatment is to control symptoms, prevent further damage, and improve quality of life.

References: [9] Sclerosing keratitis, inflammation of the cornea complicating scleritis; characterized by opacification of corneal stroma. [10] Drugs used to treat Keratitis The medications listed below are related to or used in the treatment of this condition. Select drug class All drug classes Ophthalmic anti-infectives (4) Ophthalmic steroids (6) Ophthalmic steroids with anti-infectives (17) Ophthalmic antihistamines and decongestants (3) Corticotropin (3) Glucocorticoids (10) [11] Infectious keratitis. Treatment of infectious keratitis varies, depending on the cause of the infection. Bacterial keratitis. Antibiotic eye drops are the primary treatment for bacterial keratitis. Depending on the severity of the infection, drop frequency can range from around four times a day to every 30 minutes, even during the night. [8] Microfilaricidal drugs may be used to eliminate the parasitic infection causing sclerosing keratitis.

Sclerosing keratitis is a condition characterized by inflammation and scarring of the cornea, which can lead to vision loss if left untreated. The differential diagnosis for sclerosing keratitis involves identifying other conditions that may present with similar symptoms.

Possible Causes:

• Onchocerciasis: This parasitic infection caused by the filarial parasite Onchocerca volvulus can manifest as centripetal sclerosing keratitis, where the inflammation starts from the limbal migration of the parasite [3].
• Scleritis: Severe anterior scleritis can cause inflammation and injury to the adjacent corneal layer, leading to sclerosing keratitis [6].
• Episcleritis: This condition is characterized by inflammation confined to the superficial episcleral tissue, but it can sometimes be associated with sclerosing keratitis [2].
• Interstitial Keratitis (IK): IK is a non-ulcerative inflammatory reaction in the corneal stroma that can result in sclerosing keratitis [5].
• Mooren's Ulcer: This type of peripheral ulcerative keratitis (PUK) can present with extreme eye pain, minimal discharge, and an overhanging corneal edge, which may be confused with sclerosing keratitis [4].

Other Conditions:

• Fungal Keratitis: Fungal infections can cause infiltrative keratitis, which may be mistaken for sclerosing keratitis [13].
• Viral Keratitis: Viral infections can also cause keratitis, which may present with similar symptoms to sclerosing keratitis [13].
• Acanthamoeba Keratitis: This parasitic infection can cause infiltrative keratitis, which may be confused with sclerosing keratitis [11].

It's essential to note that the differential diagnosis for sclerosing keratitis is extensive and requires a thorough examination and diagnostic workup to determine the underlying cause of the condition.

References:

[1] Not provided [2] Context 2 [3] Context 3 [4] Context 4 [5] Context 5 [6] Context 6 [7] Context 7 [11] Context 11 [13] Context 13