Keratitis – causes, symptoms and treatment

Keratitis is a painful disease that runs the gamut of annoying symptoms. Regardless of the cause, it requires ophthalmologic intervention, as in extreme cases it can result in permanent visual impairment or even loss of vision.

Treatment of keratitis should be undertaken as soon as possible. Properly treated superficial non-ulcerative keratitis does not lead to scarring, but when ulceration occurs, scarring will occur in the healing process and may need to be removed.

Everything you want to know about corneal scar removal can be found here.

Symptoms of keratitis

Inflammation of the cornea manifests itself as eye pain and deterioration of visual acuity, and can be accompanied by:

• photophobia,
• redness,
• feelings of sand in the eyes,
• Swelling and tenderness of the eyelids.

A purulent discharge may appear in the case of blue pus infection.

During the examination, the doctor will also determine the loss of corneal transparency.

Possible causes of keratitis

Inflammations of the cornea are caused by viruses, bacteria, fungi and protozoa. We also know of cases of non-infectious inflammations, such as those caused by allergens, and those associated with damage to the cornea, especially its innervation.

Bacterial keratitis

It is estimated that 90% of corneal inflammation is caused by bacteria. The most common are microorganisms of the genus:

• Neisseria gonorrhoeae (the gonorrhea bacillus),
• Staphylococcus aureus (staphylococcus aureus ),
• Haemophilus influenzae (a Gram-negative, droplet-transmitted bacterium that mainly causes respiratory infections and meningitis),
• Pseudomonas aeruginosa (blue pus bacillus).

The latter bacteria can cause the presence of purulent discharge and lead to necrosis of the entire cornea.

Treatment of bacterial keratitis requires antibiotics.

Viral keratitis

Viral keratitis is responsible for:

• Herpes Simplex Virus (HSV-1), or herpes simplex virus,
• Viruses of the adenovirus family (mainly types 8 and 19),
• Varicella Zoster Virus (VZV), which causes what is known as ocular hemiplegia.

Viral keratitis often begins with inflammation of the conjunctiva, after which it also involves the cornea.

In the treatment of corneal inflammation caused by viruses, symptomatic drugs are used to relieve the annoying symptoms of the disease and sometimes corticosteroid drugs.

Fungal conjunctivitis

Fungal keratitis can be caused by fungi such as:

• Fusarium,
• Aspergillus,
• Candida and others.

People who come into contact with contaminated objects, water, soil, work in woodworking or farming and those who do not follow strict hygiene rules when using contact lenses are at risk of infection. Also, patients with weakened immune systems, for example due to autoimmune diseases, chemotherapy, organ transplants or other immunosuppression, are more susceptible to fungal keratitis.

Treatment of fungal keratitis requires the use of fungicidal or fungostatic drugs.

Keratitis administered by protozoa

Among the protozoa that cause keratitis are amoebae of the genus Acanthamoeba. They are found in water, soil and dust. Acanthamoeba infection of the cornea often occurs in contact lens wearers, especially with poor hygiene.

Propamidine ointment and polyhexamethylene biguanide drops are used to treat protozoal keratitis.