Keratitis

Keratitis (KEHR-ah-TI-tis) is an inflammation or irritation of the cornea , often characterized by a cloudiness or loss of luster in this transparent membrane covering the iris and pupil . Acute or chronic, keratitis is a corneal inflammation that usually affects only one eye. The inflammation may be deep or superficial. Superficial keratitis is fairly common and may develop at any age. The prognosis depends on the cause.

Causes

A wide variety of conditions can lead to inflammation of the cornea. Among them are viral, bacterial, or fungal infections; exposure to ultraviolet light such as sunlight or sunlamps; exposure to other intense light sources such as welding arcs or snow or water reflections; irritation from excessive use of contact lenses; dry eyes caused by an eyelid disorder or insufficient tear formation; a foreign object in the eye; a vitamin A deficiency; or a reaction to eyedrops, eye cosmetics, pollution, or airborne particles such as dust, pollen, mold, or yeast. The condition is also a side effect of certain medications.

Symptoms

The following are the most common symptoms of keratitis. However, each child may experience symptoms differently. Symptoms may include:

pain and redness in the eye
discomfort when the child looks at a light (photophobia)
tearing, watery eyes, or discharge
blurry vision
feeling as if something is in the eye

The symptoms of keratitis may resemble other conditions or medical problems. Always consult your child's physician for a diagnosis.

Diagnostic tests

Slit-lamp examination of the eye stained with sodium fluorescein may show a portion of the cornea retaining the dye. This indicates that the patient has a corneal inflammation or abrasion. If the fluorescein-stained area shows small branch like (dendritic) lesions, a herpes simplex virus may cause the keratitis.

Treatment

Acute dendritic keratitis may respond to trifluridine eyedrops or vidarabine ophthalmic ointment, and a broad-spectrum antibiotic may prevent secondary bacterial infection.

Chronic dendritic keratitis may respond more quickly to vidarabine therapy, and long-term topical therapy may be necessary. (Corticosteroid therapy is usually contraindicated in dendritic keratitis or any other viral or fungal disease of the cornea.) For a patient with fungal keratitis, natamycin is the treatment of choice.

Keratitis caused by exposure requires applying a moisturizing ointment and a plastic bubble eye shield or eye patch over the exposed cornea. Treatment for a patient with severe corneal scarring may include keratoplasty (cornea transplantation).

Oral or eyedrop antibiotics are used for other infections, and if you wear contact lenses, you may be advised to replace your lenses. 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.

Prevention

Prevention consists of avoidance of the underlying infection, and if infected, receiving prompt and thorough treatment and follow-up.

Do not overwear contact lenses. Remove them if the eyes become red or irritated. Replace contact lenses when scheduled to do so.

Eating a well-balanced diet and wearing protective glasses when working or playing in potentially dangerous situations can reduce anyone's risk of developing keratitis. Protective goggles can even be worn mowing the lawn so that if twigs are tossed up they can't hurt the eye. Goggles or sunglasses with UV coatings can help protect against damage from UV light.

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