Keratitis – Diagnosis and Treatment
Keratitis is a condition that affects the cornea, which is the clear, dome-shaped surface at the front of the eye. The cornea plays an important role in focusing vision and protecting the inner parts of the eye from dust, germs, and other harmful substances.
When the cornea becomes inflamed, it can cause symptoms like redness, pain, and sensitivity to light. Understanding keratitis, its causes, and how it impacts eye health helps people take the right steps toward treatment and prevention.
Diagnosis
Diagnosing keratitis often begins with a careful review of symptoms. Common signs include eye redness, eye pain, blurred vision, tearing, sensitivity to light, and a foreign body sensation.
A doctor performs a detailed eye examination to check for inflammation or injury. This exam usually involves:
- Penlight Assessment: Checks pupil size and reaction.
- Fluorescein Staining: A special dye highlights damage on the corneaโs surface.
- Slit-Lamp Inspection: Uses bright light and magnification to locate corneal ulcers or other abnormalities.
| Symptom | Diagnostic Tool |
|---|---|
| Redness, pain, tearing | Eye exam, penlight |
| Blurred vision | Slit-lamp inspection |
| Foreign body feeling | Fluorescein staining |
| Vision loss | Slit-lamp, lab testing |
In some cases, the provider collects samples of tears or corneal cells for laboratory analysis. This helps pinpoint the cause and guides proper treatment.
Testing helps prevent problems like vision loss. Regular exams allow doctors to monitor inflammation and tailor care as needed.
Treatment
Care for Noninfectious Forms
Doctors manage noninfectious keratitis based on symptom severity. For minor cases, such as from a simple corneal scratch or irritation, using artificial tears can help ease discomfort and dryness.
If symptoms are more intense, like strong pain or noticeable tearing, doctors may prescribe medicated eye drops to reduce inflammation and support healing.
In certain cases, a soft bandage contact lens may also be used to protect the surface of the eye. Commonly used medications include corticosteroid eye drops. Steroids help control inflammation but require medical supervision.
Options for Infection-Related Keratitis
Doctors treat infected keratitis depending on the microbe causing the problem:
- Bacterial Cause: Doctors prescribe antibiotic eye drops as the first line of defense for bacterial keratitis. These may be given very frequently at first, sometimes even every hour or half-hour (including nights), then reduced as symptoms improve. Severe infections might require oral antibiotics as well as topical ones.
- Fungal Cause: When fungi are involved, doctors use antifungal eye drops and pills. Fungal infections are more challenging and take longer to cure.
- Viral Cause: Herpes keratitis or adenovirus-related infections usually require antiviral eye drops and possibly oral antiviral medicine. Supportive care, such as artificial tears, may also be recommended if the viral cause is mild.
- Acanthamoeba Infection: This rare parasite-related keratitis is very hard to treat. Doctors prescribe specialized antiparasitic eye drops, sometimes for several months, due to the stubborn nature of the infection. Some severe cases may require a corneal transplant.
If drug treatments do not restore vision or if the cornea is permanently damaged, corneal transplant surgery might be the only way to improve sight.
Those with weakened immune systems may have more difficulty fighting off eye infections like keratitis, and may need longer or stronger treatment. Recurrences of viral or bacterial keratitis can happen, so follow-up care is important to prevent further problems.
Getting Ready for Your Eye Care Visit
Steps You Can Take Before Your Visit
Before seeing a healthcare provider about eye symptoms, being prepared can help the visit go smoothly.
Start by calling the clinic or scheduling online, and ask if you need to follow any special rules, such as not wearing contact lenses or avoiding certain eye products before your appointment.
It is helpful to write down your symptoms. Include anything unusual you have noticed, even if it does not seem related to your eyes.
List when the symptoms started, how often they occur, and whether they improve or get worse at certain times.
Create a detailed list of all medications, supplements, and vitamins you are taking. This can include prescription medicines, over-the-counter drugs, herbal remedies, and even eye drops or creams.
Prepare some questions you want to ask the provider. Here is a sample table of possible questions:
| Question | Purpose |
|---|---|
| What might be causing my symptoms? | To understand possible reasons for the problem. |
| What tests will I need? | To know what to expect during or after the visit. |
| What are the treatment options? | To learn about your choices. |
| What should I avoid before or after treatment? | To help recovery and avoid making things worse. |
| Should I see a specialist? | To know if you need to visit another type of doctor. |
If you use contact lenses, be ready to explain how you take care of them, including how often you clean them and when you replace your lens case.
Good contact lens hygiene is important to mention, because poor cleaning habits can increase the risk of eye infections like keratitis.
Bring any eye products or contact lens supplies you use to your appointment, so the healthcare provider can check them if needed.
If you have other health issues, make a note of them. Eye symptoms can sometimes be related to problems elsewhere in the body.
Do not hesitate to ask more questions if you donโt understand something during your visit. Your healthcare provider is there to help, and clear communication is important for getting the right care.
Questions Your Provider Might Ask
During the appointment, the healthcare provider will likely ask about your eye symptoms and general health. They may want to know:
- When did the eye symptoms begin?
- Are the symptoms constant or do they come and go?
- How bad are your symptoms?
- What seems to help or make your symptoms worse?
- Have you injured your eye recently?
- Have you gone swimming or used a hot tub?
- Do you have symptoms in one or both eyes?
- Do you use contact lenses? If yes:
- Do you sleep with your contact lenses on?
- How do you clean your lenses?
- How often do you change your storage case?
- Have you had the same or similar problem before?
- Are you currently using any eye drops or have you done so recently?
- How is your general health?
- Are you taking any prescription medications or supplements?
- Have you changed your makeup or other eye products lately?
- Have you had a sexually transmitted infection in the past?
Answering these questions clearly can help the provider diagnose the problem and suggest the best treatment.
They may also ask about your hygiene habits, especially related to contact lens care. You should clean and store contact lenses as recommended to avoid infections. Regularly replacing the contact lens case also helps prevent problems.
If the provider suspects an infection, they might suggest some tests. They may take a sample from your eye or send you to an eye specialist for more detailed checks.
The healthcare provider might also give information on what to do next, possible treatment options, and when to come for a follow-up appointment.
If you do not understand the instructions or recommendations, ask for details or written information. This will help you follow the advice correctly and take care of your eyes.
