Keratitis is the medical term for inflammation of the cornea, the outermost part of the eye that covers the pupil and iris (the coloured ring around the pupil). The most common causes of keratitis are infection and injury.

Keratitis may be mild, moderate, or severe and may be associated with inflammation of other parts of the eye. Superficial keratitis involves the superficial layers of the cornea. After healing, this form of keratitis does not generally leave a scar. Deep keratitis involves deeper layers of the cornea, and the natural course leaves a scar upon healing that impairs vision if on or near the visual axis. Keratitis may affect one eye or both eyes at any one time. Keratoconjunctivitis is inflammation of the cornea and the conjunctiva.

There are many causes of keratitis. Bacteria are the most common cause. Other causes include:

• Trauma (disruption of epithelium)
• Dry eye
• Contact lens wear (Amoebic keratitis)
• Immunosuppressants
• Neurotrophic diseases
• Fungi (Fungal keratitis)
• Viruses (Viral keratitis caused by herpes simplex and herpes zoster viruses)
• UV exposure (Photokeratitis e.g. snow blindness or welder’s arc eye)

In cases where bacterial keratitis occurs, the some bacteria are capable of penetrating intact superficial cells of the cornea (epithelium), others are capable of producing keratitis only after compromisation of epithelial integrity associated with the following factors:

• Contact lens wear (especially with extended-wear soft lenses)
• Pre-existing corneal diseases (eg. Trauma, bullous keratopathy, exposure and diminished corneal sensation)
• Other factors (eg. Tear film deficiency, blepharoconjunctivitis)

Signs & Symptoms

• Foreign body sensation
• Photophobia (increased sensitivity to light)
• Blurring vision
• Pain
• Eyelid Oedema or swelling
• Discharge
• Redness

Methods of treatment for keratitis depend on the cause of the keratitis. Treatment can involve prescription eye drops, pills, or even intravenous therapy. Over-the-counter eye drops are typically not helpful in treating infections. In addition, contact lens wearers are advised to discontinue contact lens wear and discard contaminated contact lenses and contact lens cases. Some infections may scar the cornea to affect vision. Others may result in perforation of the cornea (an infection inside the eye), or even loss of the eye. With proper medical attention, infections can usually be successfully treated without long-term visual loss. The seriousness of keratitis varies widely and it is advised that one should consult an ophthalmologist or optometrist for treatment of an eye condition.

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