Keratitis

WHAT YOU SHOULD KNOW

Keratitis is an inflammation of the cornea—the domed, transparent circular portion of the front of the eyeball that lies over the pupil. 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

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.

Signs/Symptoms

Keratitis usually makes the eyes very painful and watery, bloodshot, and sensitive to light. The condition is often accompanied by blurred or hazy vision. If the herpes simplex virus is the cause, you will notice a small white spot on the cornea.

Care

Treatment depends largely on the source of the problem. If a virus is at fault, the condition is likely to clear up on its own, usually in about two to three weeks. Available medications for this form of keratitis include antiviral eyedrops (Viroptic) and ointment (Vira-A).

Keratitis brought on by a bacterial infection is usually treated with antibiotic eyedrops. These drops are also used if the keratitis is due to irritation from contact lenses or ultraviolet light. Dry eyes are typically treated by a specially formulated eyedrop solution that simulates real tears. If a medication is the culprit, it must be stopped until the eye has had time to heal.

In some cases, the doctor may gently swab or scrape the cornea to remove dead and damaged cells. Pain medications and an eye patch to prevent light from causing further irritation are often prescribed to speed recovery and provide relief from discomfort.

Risks

Depending upon the cause and severity of the keratitis, the risks run the gamut from no lasting harm to total blindness. However, most people recover from keratitis fully, and the few who do experience some degree of visual impairment can have the condition corrected with surgery or a corneal transplant. The sooner medical attention is sought, the greater your chances of complete recovery.

WHAT YOU SHOULD KNOW

• Take your medications precisely as prescribed. The eyedrops are typically needed every 12 to 24 hours, but may be required more frequently in severe cases, especially during the first 24 hours of treatment.
• To avoid unwanted drug interactions, discuss all other medications you are taking with your physician before beginning treatment.
• Wear an eye patch to prevent light from coming into contact with the afflicted eye. An eye patch may also provide some relief for pain and discomfort as well.
• Discontinue wearing contact lenses and eye make-up until the eye heals.
• Do not wear contact lenses when sleeping, even after the eye heals.
• You will most likely need extra rest during the first few days of treatment. Do not resume normal activities until you feel up to them.
• Once you return to your normal activities, wear protective glasses when performing any task that poses a potential hazard to the eyes.
• Eat a well balanced diet that contains sufficient Vitamin A or take a multivitamin. Good sources of Vitamin A include fortified milk, carrots, sweet potatoes, and liver.

Call Your Doctor If...

• Your symptoms get worse or fail to subside during the first week of treatment.
• You develop new symptoms.
• You continue to experience eye pain.
• Your vision changes or deteriorates.

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