Keratitis: Types and Treatment

07/10/2024

Keratitis is an inflammation of the cornea, the transparent front part of the eye. This condition can be caused by infections, non-infectious inflammations, prolonged use of contact lenses, ocular surface disorders such as dry eye, or autoimmune diseases. Keratitis can range from mild to severe and, if not treated properly, can lead to serious complications, including vision loss.

Types of Keratitis

Infectious

• Bacterial: It can be caused by bacteria such as Staphylococcus and Pseudomonas. It is usually common in contact lens wearers.
• Viral: Viruses such as herpes simplex (HSV) can cause keratitis. It is one of the most common causes of recurrent keratitis.
• Fungal: Fungi can cause keratitis, especially in people who have suffered an eye injury involving plant material or who improperly wear contact lenses.
• Parasitic: Acanthamoeba keratitis is rare but serious, often occurring in contact lens wearers who do not follow proper hygiene.

Non-infectious

• Eye injuries: A scratch or injury to the cornea can result in keratitis.
• Contact lens use: Prolonged or improper use of contact lenses, especially sleeping in them, increases the risk of keratitis.
• UV light exposure: Excessive exposure to ultraviolet rays, such as those reflected off snow or from tanning beds, can cause keratitis (often referred to as photokeratitis).
• Autoimmune disorders: Conditions such as Sjögren's syndrome can cause severe dry eyes, which may result in keratitis.

Symptoms

• Eye pain
• Redness of the eye
• Sensation of a foreign body or grit in the eye
• Excessive tearing or eye discharge
• Sensitivity to light (photophobia)
• Blurred vision
• Difficulty opening the eye due to pain or inflammation
• In severe cases, a corneal ulcer may develop, visible as a white or grey spot on the surface of the eye

Treatment

Treatment for keratitis depends on the underlying cause, which is why obtaining an accurate diagnosis is important. For bacterial keratitis, specific antibiotic eye drops will be prescribed based on the bacteria identified. In viral keratitis, antivirals are used, and for fungal keratitis, antifungal eye drops are prescribed. Parasitic keratitis is treated with specific antimicrobial agents. In non-infectious keratitis, resting the eyes, using lubricating eye drops, and discontinuing contact lens use if necessary are recommended. In some cases, treatment with antibiotics or antifungals may also be required to prevent secondary infections.

In addition to following the appropriate treatment, it is important to prevent keratitis by following general guidelines, such as maintaining good hygiene and using eye protection in environments with intense UV exposure. Proper use of contact lenses, without overuse, is essential to reduce the risk of keratitis. If keratitis occurs, it's important to avoid self-medication and consult an ophthalmologist early, especially in the presence of eye pain, redness, vision changes, or a visible spot on the cornea.

Dr. Victor Charoenrook, ophthalmologist at the Barraquer Ophthalmology Centre