Introduction  

Keratitis is a medical term that refers to an inflammation of the cornea. The cornea is the dome-shaped section covering the pupil and the iris.

If the inflammation only involves the surface layer of the cornea, it is known as superficial keratitis. Where the condition affects the deeper layers of the cornea, it is called interstitial or stromal keratitis.

Keratitis may also involve the edge or the centre of the cornea. The eye disorder may affect one or both eyes.
Keratitis may be mild, moderate or severe. It may also be linked to inflammation of other parts of the eye.

The eye condition may be progressive in its damage or limited in its effects. Keratitis may occur once or twice or be a chronic condition.

It is an eye disorder that is more common among people who wear contact lenses. Infectious keratitis is contagious. Non-infectious keratitis isn’t contagious unless an infection develops.

Sub-Types

  • Infectious keratitis

It is associated with an eye infection.

  • Non-infectious keratitis

It may arise from an eye injury or from wearing contact lenses for extended periods

Causes and Risk Factors

The reason depends on the type of keratitis.
Infectious keratitis may be caused by the following:

  • Bacteria
  • Viruses
  • Fungi
  • Parasitic infection
  • Contaminated water
  • Contaminated contact lenses

Non-infectious keratitis may occur due to:

  • Eye injury such as a scratch
  • Wearing contact lenses for too long
  • Wearing contacts while swimming
  • A weakened immune system
  • Exposure to intense sunlight
  • Vitamin A deficiency

Keratitis risk factors include:

  • Contact lenses
  • Eye injury
  • Reduced immunity
  • Corticosteroid eye drops
     

Signs & Symptoms

Symptoms of the eye condition include:

  • Eye pain
  • Red eye
  • Pain or irritation
  • Swelling around the eye
  • Blurred vision
  • Sensitivity to light
  • Decreased vision
     

Diagnosis

The eye professional can diagnose keratitis through a complete examination. 
The professional will conduct an eye exam to check visual acuity, a penlight exam to evaluate the pupil’s size, reaction, and other factors. A slit lamp exam helps to identify the character and extent of the eye condition.

A laboratory analysis of the patient’s tears and cells from the cornea may help to establish the cause of keratitis. It helps the eye professionals to develop a treatment plan for the eye condition.

Treatment 

Treatment is aimed at removing or relieving the inflammation.

Medical Treatment

Treatment depends on the cause of keratitis. When treated promptly, the patient is likely to recover from the eye disorder. 

In the case of infectious keratitis, the eye doctor may prescribe oral medication, eye drops or both. The remedy may include:

  • Antibiotics 
  • Antiviral 
  • Antifungal 
  • Biocides for parasitic infections

For non-infectious keratitis, the doctor gives a prescription if the condition deteriorates or develops an infection.

Surgical Treatment

Where keratitis causes significant irreversible damage to the cornea impairing vision or isn’t responding to medication, the doctor may recommend surgery. 

In severe keratitis cases, a cornea transplant may be required.

Home Care

Often, non-infectious keratitis doesn’t require medication. An eye patch helps encourage healing and can protect the affected part.

Prognosis/Long-term outlook

Depending on the cause, with early treatment, most cases of keratitis are curable.
Complications can arise if keratitis is left untreated. Potential complications include:

  • Chronic viral infections of the cornea
  • Corneal ulcers
  • Corneal scars
  • Decrease in vision
  • Long term or chronic corneal inflammation 
  • Blindness

Viral keratitis is challenging to deal with and may keep reoccurring.

Prevention/Follow Up

There are measures one can take to help prevent keratitis, especially for people who wear contact lenses. 
Prevention measures include:

Only handling contacts with clean hands
Making sure one doesn’t go to bed with contacts 
Using the right types of contacts cleaning solution; avoiding diluted solutions or water
Replacing one's contacts as recommended by an eye professional 
Removing contacts before swimming

Also, preventing viral infections can help decrease the risk of keratitis. People should make sure they wash their hands before touching their eyes.  Especially if one suspects they have been exposed to a virus.

It is also essential to wear sunglasses when outdoors. One should also use protective eyewear when engaged in hazardous undertakings. It helps to protect the eyes against injury.