Keratitis is the medical name for an inflammation of the cornea – the clear, dome-shaped window that covers the front of your eye. The condition causes pain and blurry vision, which can significantly disrupt your daily life. Keratitis may be associated with an infection. As a result, it is divided into two categories: infectious keratitis and noninfectious keratitis. Infectious keratitis is the most common form of the condition.
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Keratitis symptoms include:
- a red, irritated and bloodshot eye
- eye pain
- watery eye
- pain and irritation
- blurry vision
- reduced vision
- sensitivity to light
- a feeling that something is in your eye
What causes keratitis?
The cause of keratitis depends on the type you have.
Infectious keratitis
This type of keratitis may be caused by:
- viruses – chickenpox, the herpes simplex virus type 1 (HSV-1) or viruses that cause an upper respiratory infection may all lead to keratitis
- bacteria, fungi or parasites – common bacteria can live on the surface of a contact lens or contact lens carrying case. If you put a lens contaminated with these bacteria in your eye, it can result in infectious keratitis. Bacteria, fungi and parasites also live in water and can enter your eyes, for example when you’re swimming
- improper contact lens use – wearing contact lenses for too long, not cleaning them properly in between uses or not taking them out before swimming may all result in keratitis
- vitamin A deficiency – it is vital to get enough vitamin A in your diet, as it is essential for your vision. A vitamin A deficiency has therefore been found to present alongside infectious keratitis, and supplementation with vitamin A alongside treatment for keratitis has been found to contribute to recovery
Noninfectious keratitis
This type of keratitis may be caused by:
- injury to the cornea – if an object scratches or injures the surface of your cornea, it can lead to noninfectious keratitis. In addition, if the injury allows microorganisms to gain access to the damaged cornea, it can then lead to infectious keratitis
- dryness or inflammation of the cornea – people with dry eye are particularly at risk of keratitis
- foreign body in the eye – fragments of metal, wood, sand or glass may damage the eye and result in keratitis
- overexposure to ultraviolet light – for example, spending too long looking at sun lamps may lead to keratitis. This is also referred to as snow blindness or photokeratitis
- allergies and pollution – pollen (seasonal allergies), make-up or pollution allergies can all cause the condition
- improper contact lens use – wearing contact lenses for too long, not cleaning them properly in between uses or not taking them out before swimming may result in keratitis
When to see a consultant?
If you have any of the symptoms above, you should make an appointment to see an eye specialist straight away.
This is because mild to moderate cases of keratitis can usually be easily treated without further complications. However, if left untreated, keratitis can lead to serious complications that may permanently damage your vision.
Keratitis diagnosis
To assess whether you have keratitis, an eye specialist will conduct a thorough eye exam.
A fluorescein stain (a dye) may also be applied to the surface of your eye, as this makes it easier to see any damage to the surface of the cornea using a blue lamp.
Additionally, your doctor may conduct a slit-lamp exam using an instrument that emits a bright light, so that they can see the impact of the keratitis on your cornea more clearly.
To determine whether your keratitis is infectious or noninfectious, your eye specialist may send a sample of tears or some cells from your cornea to a laboratory for analysis. Using these results, your doctor will then be able to develop a personalised treatment plan for you.
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Keratitis treatments
The treatment plan for keratitis depends on the type of keratitis you have, its severity and the underlying cause.
For mild discomfort, artificial tear drops may be the only treatment required. However, if keratitis is causing significant tearing and pain, anti-inflammatory eye medications or a protective contact lens may be necessary.
For most causes of infectious keratitis, eye drops are likely to be prescribed. These may also be combined with oral antibiotics.
However, keratitis which is caused by a parasite called acanthamoeba can be difficult to treat. Antiparasitic eye drops tend to be used, but some strains of this parasite are resistant to medication and can require treatment for several months. If a case of acanthamoeba keratitis is persistent, a doctor may recommend a cornea transplant.
Other forms of keratitis may also require a cornea transplant — for example, if the keratitis doesn’t respond to medication or if it causes permanent damage to the cornea that significantly impairs your vision.
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