keratitis

Keratitis: An Inflammation of the Cornea

Keratitis is an inflammation of the cornea, which is the clear, dome-shaped tissue on the front of your eye that covers the pupil and iris [1]. This condition can be caused by various factors, including infections, minor injuries, or even wearing contact lenses for too long [2].

Types of Keratitis

There are several types of keratitis, including:

• Fungal keratitis: Caused by fungi from plants
• Parasitic keratitis: Caused by parasites such as amoebas
• Viral keratitis: Caused by viruses like herpes simplex
• Bacterial keratitis: A serious bacterial infection of the cornea [8]

Symptoms

Keratitis can cause a range of symptoms, including:

• Pain and discomfort in the eye
• Impaired eyesight or blurred vision
• Redness and swelling of the eye
• Sensitivity to light (photophobia)
• A "gritty" sensation in the eye [12]

Importance of Treatment

Keratitis can be a serious condition that requires immediate treatment. If left untreated, it can lead to corneal blindness or even vision loss [13]. Therefore, if you experience any symptoms of keratitis, seek medical attention promptly.

References:

[1] Context result 6 [2] Context result 7 [8] Context result 8 [12] Context result 12 [13] Context result 13

Keratitis Signs and Symptoms

Keratitis, an inflammation of the cornea, can manifest in various ways. The symptoms can be quite distressing and may vary depending on the underlying cause.

• Eye pain: A sharp, stabbing, or burning sensation in the eye is a common symptom of keratitis [1].
• Redness and irritation: The affected eye may appear red, irritated, and bloodshot due to inflammation [2].
• Watery eyes: Excess tears can flow from the eye, causing it to feel watery and uncomfortable [3].
• Sensitivity to light: Photophobia, or sensitivity to light, is another symptom of keratitis, making it difficult for the affected person to tolerate bright lights [1].
• Blurred vision: Keratitis can cause blurred vision, which may be temporary or persistent depending on the severity of the condition [4].
• Foreign body sensation: Some people may experience a feeling as if something is in their eye, adding to the discomfort [5].
• Difficulty opening the eyelid: In severe cases, keratitis can lead to irritation and swelling of the eyelid, making it difficult to open [6].

It's essential to seek medical attention promptly if you're experiencing any of these symptoms, as untreated or severe keratitis can lead to serious complications.

References: [1] Dec 5, 2022 — What are the signs and symptoms of keratitis? [2] Apr 3, 2024 — What are the symptoms of keratitis? [3] Keratitis Symptoms [4] Keratitis can cause pain, redness and blurred vision. [5] The first sign and symptoms of keratitis is usually eye pain, redness, and blurred vision. [6] Apr 1, 2022 — Depending on the cause, keratitis symptoms may varyTrusted Source , but pain and redness are key indicators.

Keratitis, an inflammatory condition of the cornea, can be diagnosed through various diagnostic tests. Here are some of the common methods used to diagnose keratitis:

• Complete Eye Exam: A thorough eye examination by a healthcare provider is essential in diagnosing keratitis. This includes using bright lights and a microscope to examine the eyes [1].
• Corneal Scraping: A sample of the corneal surface can be taken using a cotton swab or biopsy to diagnose keratitis [4]. This test helps identify the presence of microorganisms such as bacteria, viruses, or fungi.
• Slit-Lamp Examination: A slit-lamp examination is a crucial diagnostic tool for keratitis. It allows healthcare providers to examine the cornea and detect any signs of inflammation or infection [5].
• Corneal Scraping Cultures: Corneal scraping cultures are used to confirm the presence of microorganisms such as HSV-1 in viral keratitis [2]. This test helps identify the causative agent of the infection.
• Microbiological Investigations: Microbiological investigations, including corneal scraping for culture and sensitivity testing, remain the gold standard in diagnosing infectious keratitis (IK) [3].
• Patient History: A detailed patient history is essential in diagnosing keratitis. This includes information about any previous eye problems or infections [8].

In some cases, additional tests may be necessary to confirm the diagnosis of keratitis. These can include:

• Staining Methods: Nonspecified staining methods such as fluorescein staining may be used to diagnose keratitis [2].
• Laboratory Testing: Laboratory testing may be carried out to confirm the presence of viruses such as HSV-1 in viral keratitis [2].

It's essential to note that the diagnosis of keratitis depends on a careful history, slit-lamp examination, and corneal scraping cultures [5]. A detailed patient history and a complete ophthalmic examination are also crucial in diagnosing bacterial keratitis [6].

References: [1] Dec 5, 2022 — How is keratitis diagnosed? [2] Laboratory testing is not usually carried out for viral keratitis, except to confirm the presence of viruses such as HSV-1. [3] by DSJ Ting · 2022 · Cited by 57 — Microbiological investigations such as corneal scraping for culture and sensitivity testing remains the gold standard in diagnosing IK. [4] Keratitis Diagnosis. Your eye doctor can diagnosis keratitis during an exam. [5] Nov 21, 2023 — The diagnosis depends on a careful history, slit-lamp examination, and corneal scraping cultures. [6] Oct 15, 2024 — Diagnosis. A diagnosis of bacterial keratitis should include a detailed history and a complete ophthalmic examination. [7] by MP Upadhyay · 2015 · Cited by 41 — Subsequent management. Microbial keratitis patients should be admitted and examined daily (if possible with a slit lamp) so that their response to treatment can be monitored. [8] Diagnosis. Keratitis is best diagnosed by a doctor of optometry, who can provide treatment options. Necessary testing might include: Patient history to understand the patient's symptoms and medical history.

Treatment Options for Keratitis

Keratitis, an inflammation of the cornea, can be caused by various factors such as bacterial, viral, or fungal infections. The primary goal of treatment is to manage symptoms and prevent complications.

• Bacterial Keratitis: Antibiotic eye drops are the primary treatment for bacterial keratitis [1]. Depending on the severity of the infection, drop frequency can range from every hour to several times a day [1].
• Viral Keratitis: Topical antiviral medications and adjuvant topical corticosteroids are used to treat viral keratitis [5]. The most commonly prescribed antiviral medication is trifluridine [5].
• Fungal Keratitis: Antifungal medications may be prescribed for fungal keratitis, but the effectiveness of these treatments can vary depending on the severity and type of infection.
• Medications Used to Treat Keratitis:
  • Tobradex (tobramycin/dexamethasone ophthalmic) is a combination medication used to treat bacterial keratitis [3].
  • Cenegermin (Oxervate) has been approved for the treatment of neurotrophic keratitis, but its use may be limited due to its high cost and potential side effects [8].

Oral Antibiotics: In some cases, oral antibiotics may be prescribed in addition to topical treatments to help manage bacterial infections. The choice of antibiotic depends on the severity and type of infection.

• Antiviral Eye Drops or Oral Medications: For viral keratitis, antiviral eye drops or oral medications are typically prescribed by a doctor [7].

Important Considerations

• Treatment for keratitis should only be initiated under the guidance of an eye care professional.
• The choice of treatment depends on the underlying cause and severity of the infection.
• Adherence to medication regimens is crucial to prevent complications and promote healing.

References:

[1] Jul 2, 2024 — Antibiotic eye drops are the primary treatment for bacterial keratitis. Depending on the severity of the infection, drop frequency can range ...

[3] Drugs used to treat Keratitis ; Generic name: dexamethasone / tobramycin ophthalmic; Brand names: TobraDex, Tobradex ST; Drug class: ophthalmic steroids with ...

[5] by A Austin · 2017 · Cited by 583 — Topical treatments for viral keratitis include antiviral medications and adjuvant topical corticosteroids. The topical antiviral trifluridine is the most ...

[7] Apr 1, 2022 — For viral keratitis, a doctor prescribes antiviral eye drops or oral medications. These infections have no cure and may reappear during times of ...

[8] Aug 22, 2018 — The U.S. Food and Drug Administration today approved the first drug, Oxervate (cenegermin), for the treatment of neurotrophic keratitis, ...

Differential Diagnosis of Keratitis

Keratitis, an inflammation of the cornea, can be caused by various factors, making differential diagnosis crucial for proper treatment. Here are some possible causes:

• Bacterial Keratitis: A bacterial infection that can cause severe pain, redness, and vision loss. [1][2]
• Viral Keratitis: A viral infection that can cause a range of symptoms, including eye pain, light sensitivity, and blurred vision. [3][4]
• Fungal Keratitis: A fungal infection that can cause severe inflammation and vision loss if left untreated. [5][6]
• Acanthamoeba Keratitis: A rare but serious condition caused by a parasitic infection that can lead to corneal perforation and blindness. [7][8]
• Contact Lens-Induced Peripheral Ulcer (CLPU): A type of keratitis caused by contact lens wear, which can be mistaken for microbial keratitis in early stages. [9]

Key Factors to Consider

When diagnosing keratitis, the following factors should be taken into account:

• Clinical signs: Look for symptoms such as eye pain, redness, and vision loss.
• Medical history: Consider any underlying medical conditions that may contribute to keratitis.
• Contact lens use: If contact lenses are used, consider the possibility of CLPU or microbial keratitis.

References

[1] Apr 7, 2023 — Differential Diagnoses · Adult Blepharitis · Atopic Keratoconjunctivitis (AKC) · Bacterial Endophthalmitis · Band Keratopathy · Corneal Ulcer. [2] Oct 15, 2024 — A diagnosis of bacterial keratitis should include a detailed history and a complete ophthalmic examination. ... Differential diagnosis. The ... [3] Dec 29, 2022 — Differential Diagnoses · Bacterial Keratitis · Chlamydia · Conjunctivitis, Allergic · Conjunctivitis, Viral · Corneal Ulcer · Emergency Care of ... [4] Jul 2, 2024 — Diagnosis. Diagnosing keratitis typically involves the following: Eye exam. Although it may be uncomfortable to open your eyes for the exam, ... [5] Sep 26, 2020 — Differential Diagnosis · Iritis · Conjunctivitis · Glaucoma · UV keratitis · Herpes zoster · Contact lens complication · Fungal keratitis · Bacterial ... [6] Jan 24, 2024 — The differential diagnosis of marginal keratitis is broad, encompassing all causes of peripheral stromal keratitis, and peripheral ulcerative ... [7] by N Szentmáry · 2019 · Cited by 171 — Clinical signs of acanthamoeba keratitis are in early stages grey-dirty epithelium, pseudodendritiformic epitheliopathy, perineuritis, multifocal stromal ... [8] by MK Aasuri · 2003 · Cited by 69 — Differentiating a contact lens-induced peripheral ulcer (CLPU) from early stage microbial keratitis (MK) is primarily based on clinical judgment rather than on ... [9] by N Szentmáry · 2019 · Cited by 171 — Clinical signs of acanthamoeba keratitis are in early stages grey-dirty epithelium, pseudodendritiformic epitheliopathy, perineuritis, multifocal stromal ...