Keratitis

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Keratitis
Classification and external resources
Clare-314.jpg
An eye with non-ulcerative sterile keratitis.
ICD-10 H16
ICD-9 370
DiseasesDB 7150
MeSH D007634

Keratitis is a condition in which the eye's cornea, the front part of the eye, becomes inflamed. The condition is often marked by moderate to intense pain and usually involves impaired eyesight. It may cause feelings of itchiness each time the individual blinks.[1]

Types[edit]

Superficial keratitis involves the superficial layers (i.e. the epithelium) of the cornea. After healing, this form of keratitis does not generally leave a scar.

Deep keratitis involves deeper layers of the cornea (i.e. The epithelium, Bowman's Membrane and often stroma), and the natural course leaves a scar upon healing that impairs vision if on or near the visual axis. This can be reduced or avoided with the use of topical corticosteroid eyedrops.

Causes[edit]

Keratitis has multiple causes, one of which is an infection of a present or previous herpes simplex virus secondary to an upper respiratory infection, involving cold sores.

Pathogens[edit]

Other[edit]

Diagnosis[edit]

Effective diagnosis is important in detecting this condition and subsequent treatment as keratitis is sometimes mistaken for an allergic conjunctivitis.

Treatment[edit]

Treatment depends on the cause of the keratitis. Infectious keratitis can progress rapidly, and generally requires urgent antibacterial, antifungal, or antiviral therapy to eliminate the pathogen. Treatment is usually carried out by an optometrist or ophthalmologist and can involve prescription eye medications, systemic medication, or even intravenous therapy. It is inadvisable to use over-the-counter eye drops as they are typically not helpful in treating infections, also using them could delay correct treatment, increasing the likelihood of sight threatening complications. In addition, contact lens wearers are typically advised to discontinue contact lens wear and replace contaminated contact lenses and contact lens cases. (Contaminated lenses and cases should not be discarded as cultures from these can be used to identify the pathogen).

Antibacterial solutions include levofloxacin, gatifloxacin, moxifloxacin, ofloxacin. It is unclear if steroid eye drops are useful or not.[8]

Aciclovir is the mainstay of treatment for HSV keratitis and steroids should be avoided at all costs in this condition. Application of steroids to a dendritic ulcer caused by HSV will result in rapid and significant worsening of the ulcer to form an 'amoeboid' or 'geographic' ulcer, so named because of the ulcer's map like shape.[citation needed]

Prognosis[edit]

Some infections may scar the cornea to limit 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.

See also[edit]

References[edit]

  1. ^ Keratitis
  2. ^ Martín-Navarro, M.; Lorenzo-Morales, J.; Cabrera-Serra, G.; Rancel, F.; Coronado-Alvarez, M.; Piñero, E.; Valladares, B. (Nov 2008). "The potential pathogenicity of chlorhexidine-sensitive Acanthamoeba strains isolated from contact lens cases from asymptomatic individuals in Tenerife, Canary Islands, Spain". Journal of medical microbiology 57 (Pt 11): 1399–1404. doi:10.1099/jmm.0.2008/003459-0. ISSN 0022-2615. PMID 18927419.  edit
  3. ^ CDC Advisory
  4. ^ Tang A, Marquart ME, Fratkin JD, McCormick CC, Caballero AR, Gatlin HP, O'Callaghan RJ (2009). "Properties of PASP: A Pseudomonas Protease Capable of Mediating Corneal Erosions". Invest Ophthalmol Vis Sci 50 (8): 3794–801. doi:10.1167/iovs.08-3107. PMC 2874894. PMID 19255155. 
  5. ^ "What is onchocerciasis?". CDC. Retrieved 2010-06-28. "transmission is most intense in remote African rural agricultural villages, located near rapidly flowing streams...(WHO) expert committee on onchocerciasis estimates the global prevalence is 17.7 million, of whom about 270,000 are blind." 
  6. ^ Optometry.co.uk
  7. ^ VET.uga.edu
  8. ^ Herretes, S; Wang, X; Reyes, JM (2014 Oct 16). "Topical corticosteroids as adjunctive therapy for bacterial keratitis.". The Cochrane database of systematic reviews 10: CD005430. PMID 25321340.  Check date values in: |date= (help)

External links[edit]