Keratitis

keratitis is an eye inflammation. This inflammation of the cornea (keratitis) may be acute or chronic, superficial or deep. Superficial keratitis is fairly common and may develop at any age. The prognosis is good with treatment. If keratitis is untreated, recurrent keratitis may lead to blindness.

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.

Causes of keratitis

Keratitis may result from exposure (such as in Bell's palsy where the eyelids don't close). It may also result from infection by herpes simplex virus, type 1 (known as dendritic keratitis because of a characteristic branched lesion of the cornea resembling the veins of a leaf). Less commonly, it stems from bacterial and fungal infections and, rarely, from congenital syphilis.

Signs and symptoms of keratitis

Unilateral keratitis may produce mild irritation, tearing, and photophobia. If the infection is in the center of the cornea, it may produce blurred vision. Left untreated, corneal opacities can occur. When keratitis results from exposure, it usually affects the lower portion of the cornea. The symptoms of keratitis may resemble other conditions or medical problems. Always consult your child's physician for a diagnosis.

A slit-lamp examination reveals the depth of the keratitis. If keratitis is due to herpes simplex virus, staining the eye with a fluorescein strip produces one or more small branch like (dendritic) lesions; touching the cornea with cotton reveals reduced corneal sensation. Vision testing may show slightly decreased acuity. The patient history may reveal a recent infection of the upper respiratory tract accompanied by cold sores.

Home remedies for the treatment of keratitis

A sterile, cotton-tipped applicator may be used to gently remove infected tissue and allow the eye to heal more rapidly. 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. Minor keratitis (corneal) infections are commonly treated with anti-bacterial or anti-fungal eye drops. For cases caused by dry eye, artificial tears for lubrication are usually effective. Vitamin supplementation is given in cases where a vitamin A deficiency is the suspected cause. If the problem is more severe, a person may receive more intensive antibiotic treatment as under to eliminate the infection.

In acute keratitis due to herpes simplex virus, treatment consists of trifluridine eye drops or vidarabine ointment. A broad-spectrum antibiotic may prevent secondary bacterial infection. Chronic dendritic keratitis may respond more quickly to vidarabine. Long-term topical therapy may be necessary. (Corticosteroid therapy is contraindicated in dendritic keratitis or any other viral or fungal disease of the cornea.) Treatment for fungal keratitis consists of natamycin. Keratitis due to exposure requires application of moisturizing ointment to the exposed cornea and of a plastic bubble eye shield or eye patch. Treatment for severe corneal scarring may include keratoplasty (cornea transplantation).

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