Dr. Orwa Nasser MD MPH - Keratitis

Keratitis

Keratitis is inflammation of the cornea, the transparent front surface of the eye that helps focus vision. When the cornea becomes inflamed, it may cause pain, redness, blurred vision, and sensitivity to light. Keratitis may be infectious or noninfectious, and both forms require prompt medical evaluation.

Symptoms:

    ·    Eye pain or discomfort.

    ·    Red or bloodshot eye.

    ·    Excess tearing or discharge.

    ·    Blurred or decreased vision.

    ·    Sensitivity to light.

    ·     Foreign-body sensation.

    ·     Difficulty opening the eye due to irritation.

Causes: Keratitis may be infectious or noninfectious in origin.

·    Infectious keratitis: Bacteria, viruses, fungi, and parasites may infect the cornea, particularly after surface injury or in contact lens wearers.

·    Noninfectious keratitis: Corneal trauma, dry eye, ultraviolet exposure, autoimmune disease, or prolonged contact lens wear may trigger inflammation without infection.

Diagnosis and Tests:

·    Diagnosis is made through detailed eye examination and medical history review.

·    A slit-lamp examination evaluates the corneal surface and depth of inflammation.

·    Fluorescein staining highlights epithelial defects.

·    Corneal cultures may be obtained if infection is suspected.

Management and Treatment: Treatment depends on the underlying cause and severity of inflammation.

·    Infectious treatment:

o   Bacterial keratitis requires topical antibiotics.

o   Viral keratitis may require antiviral medications.

o   Fungal keratitis is treated with antifungal therapy.

o   Parasitic keratitis requires specialized antimicrobial treatment.

·    Noninfectious management:

o   Lubricating drops help relieve irritation and support healing.

o   Contact lens wear should be stopped until full recovery.

o   Anti-inflammatory medications may be used cautiously under specialist supervision.

Prognosis: With early treatment, many cases resolve without permanent vision loss. Delayed treatment may result in corneal scarring or ulcer formation. Severe infections can lead to long-term visual impairment.

Prevention:

    ·    Follow strict contact lens hygiene guidelines.

    ·    Avoid overnight contact lens wear unless prescribed.

    ·    Protect eyes from trauma and ultraviolet exposure.

    ·    Seek prompt care for eye redness or pain.

When Should I See My Healthcare Provider?  Seek evaluation if you develop eye pain, redness, blurred vision, or light sensitivity.

When Should I Go to the Emergency Room? Go immediately if symptoms worsen rapidly, vision decreases suddenly, or severe pain develops.

What Questions Should I Ask My Healthcare Provider?

    ·    Is my keratitis infectious or noninfectious?

    ·    What treatment do I need?

    ·    How long will recovery take?

    ·    When can I resume contact lens use?

    ·    What warning signs should I monitor?

Key Takeaways:

    ·    Keratitis is inflammation of the cornea.

    ·    It may be infectious or noninfectious.

    ·     Early treatment prevents complications.

    ·     Proper contact lens hygiene reduces risk.

    ·     Severe cases may threaten vision if untreated.