Keratitis

Keratitis is a condition in which inflammatory cells move into different layers of the cornea in response to harmful stimuli, such as bacteria or self-antigens.

Last Updated: February 25, 2024

The inflammatory reaction may cause the corneal epithelium and stroma to melt and accumulate, leading to ulcers. This not only makes the cornea less clear but also puts the integrity of the globe at risk.

The source of infection can be bacteria, protozoa, fungi, viruses, or helminths. Non-infectious keratitis can be caused by: injuring the eye; too much time spent with contact lenses; getting something stuck in the eye; too much exposure to UV (ultraviolet) light.

Corneal ulcers are more likely to happen to middle-aged men than to middle-aged women. Farmers are at high risk because of what they do for a living. In developing countries, corneal ulcers caused by fungi are very common.

  • Eye pain
  • Wet eyes
  • Eyes that are red, itchy, and bloodshot
  • Light sensitivity (photophobia)
  • Vision is blurry
  • Difficulty in lifting the eyelid
  • A sensation that something is directly touching your eye

An eye doctor may do any or all of the following tests:

  • For a complete eye exam, a doctor will look at the eyes with bright lights and a microscope;
  • A doctor swabs the discharge from the eye and sends it to a lab so that the organism causing the discharge can be identified;
  • Fluorescein stain test is where a doctor puts a dye in the eye and then uses a blue lamp to look at the eyes.

Treatment

Patients with bacterial keratitis are given extra topical antibiotics until the culture results come back. When the specific pathogen is found, a doctor will usually prescribe a specific type of antibiotic that targets the identified pathogen.

 

PHMB and chlorhexidine are used to treat protozoal keratitis. Keratitis caused by oomycete is treated with both topical and oral linezolid and azithromycin. For filamentous fungal keratitis, topical natamycin is used. Topical steroids are used to treat endothelitis and HSV stromal disease.

 

Keratitis can scar the cornea, so a cornea transplant may be necessary if medicine does not help and the scarring persists.

You can reduce the risk of getting keratitis by: 

  • Avoid wearing your contact lenses for an extended time
  • Make sure your hands are clean before touching your eyes
  • Follow the directions for how to clean and disinfect your contact lenses
  • To avoid damaging your contact lenses, avoid water activities such as swimming, showering, and soaking in a hot tub
  • Using good hand-washing techniques and staying away from sick people are good ways to keep from getting sick
  • Putting on safety glasses while working and playing sports
  • Putting on sunglasses to keep UV light from hurting your eyes. 

References

Singh P, Gupta A, Tripathy K. Keratitis. [Updated 2022 Nov 15]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK559014/

 

Cleveland Clinic (2022). Keratitis. Retrieved December 16, 2022, from https://my.clevelandclinic.org/health/diseases/24500-keratitis

Last Updated: February 25, 2024