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Keratitis - Causes, Symptoms & Treatment


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Keratitis is an inflammation of the cornea the domed, transparent circular portion of the front of the eyeball that lies over the pupil. The infection occurs almost exclusively in contact lens wearers. The patient will present with a unilateral, acutely painful, photophobic, intensely injected eye. Upon healing, a scar remains that impairs vision if on or near the visual axis. Keratitis has many causes including bacteria, viruses and fungi. It typically occurs after trauma associated with plant matter or in immuno-compromised individuals. Keratitis is a medical emergency because extensive involvement may lead to blindness. Microbial keratitis results from the interaction of a broad spectrum of pathogens and a diverse range of host responses.

This condition is typically accompanied by severe pain, redness, and scant (if any) discharge. The conjunctival and episcleral vessels will be deeply engorged and inflamed, often greatly out of proportion to the size of the corneal defect. Superficial keratitis involves the superficial layers of the cornea. It should be noted that microbial infections such as keratitis, although relatively infrequent, are the most serious complication of contact lens wear. Fusarium is commonly found in organic matter such as soil and plants. The cornea is the clear, dome-shaped surface that covers the front of the eye. Symptoms of corneal infection include extreme pain and photophobia. It is characterized by small pinpoint defects in the superficial corneal epithelium, which stain with fluorescein. The primary treatment modality for ocular infections from Fusarium is natamycin, but not all infections respond to this drug.

Causes of Keratitis

Common causes and risk factor's of Keratitis include the following :

  • Fungi.
  • Trauma (usually following insertion of an object into the eye).
  • Vitamin A deficiencies.
  • Bacteria.
  • Parasites.

Symptoms of Keratitis

Some common Symptoms of Keratitis:

  • Pain.
  • Blurred vision.
  • Light sensitivity .
  • Impaired vision.
  • Discharge.
  • Itching and discharge
  • Tearing, watery eyes,
  • Redness.
  • Watery eyes
  • Feeling as if something is in the eye.

Treatment of Keratitis

  • Corticosteroid eye drops may be used to reduce inflammation in certain conditions. Severe ulcers may need to be treated with corneal transplantation.
  • Bacterial corneal ulcers require intense topical eye drop instillation every 1/2 hour for the first 48 hours with two broad-spectrum antibiotics. Treatment for fungal keratitis consists of natamycin. Bacterial and fungal corneal ulcers are treated in hospital.
  • Treatment of the cornea with corticosteroid drops may minimize scarring, and help preserve the clarity of the cornea.
  • Minor corneal infections are commonly treated with anti-bacterial or anti-fungal eye drops. If the problem is more severe, a person may receive more intensive antibiotic treatment to eliminate the infection and may need to take steroid eye drops to reduce inflammation.
  • Treating corneal ulcers and infections depends on the cause. They should be treated as soon as possible to prevent further injury to the cornea.