Keratitis

GENERAL INFORMATION:

What is keratitis? Keratitis (ker-ah-TEYE-tis) is an inflammation (swelling) of the cornea. The cornea is the thin, colorless covering in the front of the eye. It protects the iris (colored part of the eye) and pupil (opening of the eye where light passes through). Keratitis may be ulcerative (open sores) or non-ulcerative (no sores), and is commonly caused by an infection. It usually affects one eye but can sometimes affect both eyes. It is a serious problem that may result in loss of vision due to scarring of the cornea.

What causes keratitis?

• Eye infection: Keratitis caused by an eye infection usually happens after eye trauma or surgery. An eye infection may be due to any of the following:
  
  
  • Bacteria: Different bacteria (germs), such as those that cause tuberculosis, leprosy, and syphilis, may cause keratitis. Newborn babies may get infected with bacteria as they pass through the mother's birth canal.
    
    
  • Fungus: In some cases, keratitis may be caused by a fungus (yeast-like germs). These are organisms which usually cause problems when the immune system becomes weak. The immune system is the part of your body that fights infection.
    
    
  • Parasite: Infection by a parasite (bug) usually occurs with poor hygiene, such as in poor contact lens care. You may also get the parasite by using contaminated (dirty) water or contaminated eye drops.
    
    
  • Viruses: Viruses that cause cold sores or chicken pox may also cause keratitis.
  
  
• Other diseases: Keratitis may happen as a result of diseases causing inflammation. These may include autoimmune diseases, such as rheumatoid arthritis and Wegener's granulomatosis. An autoimmune disease is a condition where your body's immune system attacks some of its own cells. No one knows for sure what causes these autoimmune diseases.

Who is at a high risk of getting keratitis? The following conditions and factors may make you more likely to develop keratitis:

• Being malnourished (having poor nutrition) or lacking vitamin A. Drinking a lot of alcohol too often may also cause keratitis. Alcohol is found in beer, wine, liquor (such as vodka or whiskey), and other adult drinks.
  
  
• Eye trauma, which may be caused by a foreign body, chemical, heat, or radiation.
  
  
• Having eye surgery in the past.
  
  
• Having other eye problems, such as dry eyes, inverted eyelashes (eyelashes growing into the eye), and eyelid problems. An infection near or around the eye, such as conjunctivitis (sore eyes), may also lead to keratitis.
  
  
• Having a weak immune system, such as in AIDS patients. Other medical conditions, such as diabetes or being hooked to a respirator (breathing device), may also increase your risk.
  
  
• Using steroids that are applied directly to the eyes or certain medicines that come into contact with the eye.
  
  
• Wearing contact lenses for a longer period of time than recommended, such as the extended wear type.

What are the signs and symptoms of keratitis? You may have any of the following:

• Blurred vision or cloudy cornea.
  
  
• Eye pain, feeling that something is in the eye, or a decreased feeling in the cornea.
  
  
• Increased discomfort when the eye is exposed to light.
  
  
• Redness or sores in the eye.
  
  
• Swelling of the eyelid.
  
  
• Tearing or watering of the eye or an eye discharge.
  
  
• Uncontrolled, continuous blinking or eyelid twitches or tics.

How is keratitis diagnosed? Your caregiver may need your detailed health history. He may also need to know if you wear contact lenses and how often you use them. Other important information that your caregiver may need to know about is past infections, diseases, surgeries, or medicines you are taking. You may need any of the following tests:

• Eye exam: A complete eye exam includes testing your vision, eye movements, and eye pressure.
  
  
  • Visual acuity test: Your caregiver may ask you to read an eye chart. This chart helps your caregiver check how well you see at different distances.
    
    
  • Slit-lamp test: This test uses a microscope with a strong light to look into your eyes. It is used to check the inside parts of your eye and the area around it.
  
  
• Biopsy: This is a procedure where caregivers remove a small piece of tissue from the affected area of the eye. This sample is then sent to the lab for tests. A biopsy helps caregivers look for the cause of your disease.
  
  
• Blood tests: You may need blood taken for tests. The blood can be taken from a blood vessel in your hand, arm, or the bend in your elbow. It is tested to see how your body is doing. It can give your caregivers more information about your health condition. You may need to have blood drawn more than once.
  
  
• Culture and smear exam: A sample is scraped from the affected eye and is placed in a special solution. The sample is then checked under the microscope. A culture and smear exam may help caregivers learn what is causing your disease. It may also tell your caregiver which medicine is best used to treat the disease.

How is keratitis treated? Treatment will depend on the cause of keratitis and how bad the condition is. You may have any of the following:

• Medicines:
  
  
  • Antibiotics: Antibiotics may be given to help treat or prevent an infection caused by germs called bacteria.
    
    
  • Antifungal medicine: This medicine helps kill fungus that can cause illness.
    
    
  • Antiparasitic medicine: This medicine may be given to kill parasites. Parasites are living things that feed or eat off of other living things.
    
    
  • Antiviral medicine: Antiviral medicine may be given to fight an infection caused by a germ called a virus.
    
    
  • Steroids: Steroid medicine may be given as an eyedrop to decrease inflammation in your eye.
  
  
• Surgery: You may need to have surgery if your cornea is badly damaged. A cornea from a donor may be put into your eye to replace the damaged part of your cornea.

How can keratitis be prevented?

• Always wear safety glasses, eye shields, or goggles when working with power tools, gardening, or playing sports.
  
  
• Do not rub your eyes while working with wood or metal pieces. If a foreign body gets into your eye, do not rub your eye or try to remove the object.
  
  
• The correct use of contact lenses is very important. Know when and how long they can be used, and how to clean and store them properly.
  
  
• Prevent or treat risk factors, such as controlling diabetes. Follow the directions of your caregiver when treating other eye problems.
  
  
• You may need to take antibiotics if you are at a very high risk of getting keratitis. They are usually given when you have other infections in the body that are caused by bacteria. Ask your caregiver for more information on taking antibiotics for prevention of keratitis.

Where can I find more information? Contact the following for more information:

• American Academy of Ophthalmology
  7424
  San Francisco, CA 941207424
  Phone: 1-415-5618500
  Web Address: http://www.aao.org/
  

CARE AGREEMENT:

You have the right to help plan your care. To help with this plan, you must learn about your health condition and how it may be treated. You can then discuss treatment options with your caregivers. Work with them to decide what care may be used to treat you. You always have the right to refuse treatment.

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