Keratitis: what it is, symptoms, treatment, cure and more

What is keratitis

Also known as keratitis or keratomalacia, keratitis is an inflammation of the cornea, a transparent layer that has the function of protecting our eye. The lesion may be infectious or not and has several causes, the most common of which is the use of infected contact lenses.

When treated early and in the right way, keratitis evolves favorably, that is, there is no possibility of loss of vision. However, when medical help is late, some complications can happen, such as corneal ulcers or temporary or permanent vision reduction.

What are the causes?

Most reported cases of keratitis have an infectious origin, but it can also be caused by other factors. Check out the main causes of the disease in the list below:

  • Physical injury: frequently scratching the cornea can injure the cornea, allowing irritants or even infectious agents to enter.
  • Contaminated contact lenses: this is one of the most common causes of the disease and is usually caused by the fact that the lenses are contaminated by the microorganism Acanthamoeba , a protozoan that inhabits water sources and that can be allocated on lenses that are not properly clean and preserved.
  • Virosis: this cause is affected, in most cases, by the Herpes simplex or Herpes zoster viruses .
  • Bacteriosis: in case of bacteriosis, keratitis can be caused by the bacteria Staphylococcus aureus , Pseudomonas aeroginosa or Chlamydia trachomatis .
  • Ringworm: fungi usually enter the cornea through cuts or small cuts that it has. The species that can cause keratitis in this case are Fusarium , Aspergillus or Candida .
  • Nematodes: rarest cause of keratitis – practically only in Africa -, the disease is transmitted by black flies Loa loa , Toxocara or Oncocera or by direct contact with the contaminated soil.
  • Dryness: If your tear glands do not produce enough tears to keep the cornea lubricated or if there is a blockage in their flow, you can develop a secondary inflammation, called xerophthalmia, which can cause keratitis.
  • Chemical injury: this cause occurs through contact with very acidic or very alkaline liquids.
  • Complication of another disease: keratitis usually develops when another eye disease, conjunctivitis , is not treated properly.

The types in which the disease presents itself

There are several types of keratitis and, as already mentioned, it can be infectious or not. Below are the main types of the disease:

Infectious ceratite

Among the pathological agents that can cause keratitis are:

  • Virus;
  • Bacteria;
  • Protozoa (amoebae);
  • Fungi;
  • Worms.

It is important to note that this type of keratitis can be transmitted to other people. Therefore, always take care to wash your hands properly, avoid scratching your eyes and do not share personal effects with third parties.

Non-infectious keratitis

This type of keratitis can be caused by trauma, irritating agents, misuse of some eye drops, etc.

 

Ceratoconjuntivite sicca

This inflammation is due to the inability to produce enough tears or the blockage of circulation. It occurs in autoimmune diseases , which end up damaging the lacrimal glands, such as:

  • Sjogren’s syndrome;
  • Vitamin A deficiency.

Interstitial ceratite

Interstitial keratitis is a type of keratitis that affects the entire cornea.

Neuropathic ceratite

This type of keratitis occurs as a consequence of the interruption of sensory impulses on the trigeminal nerve (the fifth cranial nerve).

Rosacea ceratite

Complication of acne rosacea, an autoimmune disease, which causes the antimicrobial catelicidin to induce the allergic response in an exaggerated way.

Pointed ceratite

This is a type of keratitis in which only the corneal epithelium is involved. It presents as corneal micro ulcers.

Filamentary ceratite

Filamentary – or filamentous – keratitis occurs when the superficial cells of the cornea detach from it, causing small ulcers.

Dendritic ceratite

A subsequent infection is called dendritic keratitis. It is characterized by a pattern of corneal lesions, which resemble branches of trees.

Ceratite bolhosa

In this type of keratitis, stromal corneal edema occurs , accompanied by epithelial and subepithelial bubbles. When the case is severe, the need for corneal transplantation is great.

Risk factors

All people are liable to develop keratitis if they are not properly cared for. However, some factors can increase the risk of this infection:

  • Use of contact lenses;
  • Low immunity;
  • Living in a hot and humid climate;
  • Use of corticosteroids (usually found in eye drops);
  • Eye injury;
  • Historic ceratite.

Symptoms of Keratitis

Some signs and symptoms of keratitis are quite characteristic, such as:

  • Intense redness in the eyes;
  • Pain in the eyes;
  • Excessive tears;
  • Difficulty opening the eyelids due to pain or irritation;
  • Blurry vision;
  • Decreased vision;
  • Sensitivity to light (photophobia);
  • Sensation that there is something in your eyes permanently.

Usually, keratitis presents in only one eye, but occasionally it can develop in both eyes simultaneously.

What is the diagnosis?

If you have seen one or more symptoms of keratitis in your eyes, make an appointment with a trusted eye doctor. That way, he will be able to examine you and perform tests to diagnose whether what you have is keratitis or not.

Among the exams that the specialist can do are:

  • Eye examination: This is a general examination that includes an effort to determine how well you can see.
  • Examination of the flashlight: in this case, the doctor will perform the examination with the aid of a flashlight, to check the reaction of your pupil in the light emitted.
  • Examination of the slit lamp: in this case, the examination is done with a special instrument called a slit lamp. This instrument provides a bright and very intense light, which allows the doctor to see structures of your eye with high magnification.
  • Laboratory analysis: for laboratory analysis, a sample of tears or corneal cells can be sent to a laboratory so that the cause of keratitis is detected and, thus, to be able to know which treatment to resort to.

Treatments for Keratitis

For the treatment of this disease, it is necessary to know precisely what its cause is. Basically, this can be divided into two categories: treatment for infectious keratitis and treatment for non-infectious keratitis.

Non-infectious keratitis

Depending on the cause of keratitis, the condition may not need treatment. However, if you have a lot of pain or excessive tears, it is likely that you will need to apply some medication, duly prescribed by your doctor, and use an eye patch until your condition improves.

Infectious ceratite

In the case of infectious keratitis, treatment will vary according to the agent that caused the disease.

  • Bacterial keratitis: in most cases, antibacterial eye drops solve the case. If your infection is more severe, you may need to take oral antibiotics as well.
  • Fungal keratitis : keratitis caused by fungi can be treated with eye drops and antifungal drugs.
  • Viral keratitis: if your keratitis was caused by a virus, treatment is based on antiviral eye drops and, depending on the case, on antiviral drugs as well. However, these drugs may not completely eliminate the causative virus, which can lead to a new picture of keratitis later.
  • Protozoal keratitis : keratitis caused by the protozoan Acanthamoeba is usually difficult to treat, as this microorganism is very resistant to several drugs. However, even so, antibiotic eye drops can be of great help.

If even with these treatments your infection persists, as it is very severe, your doctor may recommend corneal transplantation.

Attention! 

NEVER self-medicate or stop using a medication without first consulting a doctor. Only he will be able to tell which medication, dosage and duration of treatment is the most suitable for his specific case. The information contained on this site is only intended to inform, not in any way intended to replace the guidance of a specialist or serve as a recommendation for any type of treatment. Always follow the instructions on the package insert and, if symptoms persist, seek medical or pharmaceutical advice.

Complications

If not treated properly, keratitis can present some complications. Are they:

  • Chronic corneal inflammation;
  • Recurrent or chronic viral infections of the cornea;
  • Open wounds on the cornea (corneal ulcer);
  • Corneal swelling and scarring;
  • Reduction of temporary or permanent vision;
  • Blindness.

Prevention

As most cases of keratitis happen due to poor cleaning and conservation of contact lenses, some care must be taken with them in order to prevent the disease.

  • Perform proper hand hygiene before handling the lenses;
  • Remove the lenses before going to sleep;
  • Use products indicated by the doctor to clean the lenses;
  • Change the lenses in the recommended period;
  • Do not reuse the ophthalmic solution used to clean the lenses;
  • Do not wear lenses when swimming.

In addition to these precautions, others may also be taken:

  • If you have cold sore or herpes on your body, avoid putting your hands over your eyes;
  • Do not use eye drops that contain corticosteroids unless they have been prescribed by your doctor;
  • If you wear contact lenses and have had several occurrences of viral keratitis, stop using them until your case is 100% cured.

With the right care, the disease will have less chance of developing in your body, thus making you have a more peaceful and healthy life.

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