Information on Keratitis

By: peterhutch

Keratitis is an inflammation of the cornea-the domed, transparent circular portion of the front of the eyeball that lies over the pupil. There are several types, including superficial punctate keratitis, in which the cells on the surface of the cornea die; interstitial keratitis, a condition present at birth; herpes simplex viral keratitis, caused by the sexually transmitted herpes virus; and traumatic keratitis, which results when a corneal injury leaves scar tissue.

Bacterial corneal ulcers generally follow a traumatic break in the corneal epithelium, thereby providing an entry for bacteria. The traumatic episode may be minor, such as a minute abrasion from a small foreign body, or it may result from such causes as tear insufficiency, malnutrition, or contact lens use.

Increased use of soft contact lenses in recent years has led to a dramatic rise in the occurrence of corneal ulcer, particularly due to Pseudomonas aeruginosa. In addition, with the introduction of topical corticosteroid drugs in the treatment of eye disease, fungal corneal ulcers have become more common.

This infection generally begins with inflammation of the membrane lining the eyelid (conjunctiva) and the portion of the eyeball that comes into contact with it. It usually occurs in one eye. Subsequent infections are characterized by a pattern of lesions that resemble the veins of a leaf. These infections are called dendritic keratitis and aid in the diagnosis.

A patient with keratitis may wear a patch to protect the healing eye from bright light, foreign objects, the lid rubbing against the cornea, and other irritants. Sometimes a patch can make it worse, so again, the patient must discuss with the doctor whether or not a patch is necessary. The patient will probably return every day to the eye doctor to check on the progress.

While Fusarium keratitis can be a serious infection, it is a rare disease. Fusarium is commonly found in organic matter such as soil and plants. This infection cannot be transmitted from person to person. People who have trauma to the eye, certain eye diseases and problems with their immune system may be at increased risk for these types of infection.

This problem appears as fine, scattered areas of loss of epithelium from the cornea - the clear part of the surface of the eye. The lesions appear punctate (looking like dots or points) but sometimes can appear dendritic (linear and branching). Superficial punctate keratitis is uncommon and not communicable. Characteristically, there is no residual scarring and long-term vision problems are rare.
Recurrences may be brought on by stress, fatigue, or ultraviolet light (UV) exposure (e.g., skiing or boating increase the exposure of the eye to sunlight; the sunlight reflects off of the surfaces). Repeated episodes of dendritic keratitis can cause sores, permanent scarring, and numbness of the cornea.

Treatment depends on the cause of the keratitis Infectious keratitis generally requires antibacterial, antifungal, or antiviral therapy is to treat the infection. This treatment can involve prescription eye drops, pills, or even intravenous therapy. Over-the-counter eye drops are typically not helpful in treating infections. In addition, contact lens wearers are typically advised to discontinue contact lens wear and discarding contaminated contact lenses and contact lens cases. Antibacterial solutions include Quixin (levofloxacin), Zymar (gatifloxacin), Vigamox (moxifloxacin), Ocuflox (ofloxacin - available generically). Steroid containing medications should not be used for bacterial infections, as they may exacerbate the disease and lead to severe corneal ulceration and corneal perforation.

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