Keratitis

An introduction to keratitis

Keratitis is an inflammation of the cornea of the eye. The cornea is the transparent dome at the front of the eye that covers the iris and pupil. Keratitis can be a serious condition, because if left untreated for too long it can cause ulcers which can lead to scarring and blindness.

Keratitis can occur on the surface of the cornea (epithelial or superficial keratitis) or in the deeper layers of the cornea (stromal keratitis).

What are the symptoms of keratitis?

The common symptoms of keratitis are:

• A red eye
• A watering eye, or an increase in discharge from the eye
• Blurry vision
• Decrease in vision
• Sensitivity to light – also known as photophobia
• The feeling of having a foreign body in your eye
• Pain in the eye.

A number of these symptoms are similar to the symptoms of conjunctivitis, such as the red eye, watering eye or eye discharge. However, if you notice significant pain or deteriorating vision you must seek medical advice as soon as possible, as these are indications of keratitis.

What are the causes of keratitis?

There are a few causes of keratitis. The most common are:

• Eye injury – an injury to the cornea can leave it vulnerable to infection, or a foreign body stuck in the cornea can cause inflammation. Injury can also come in the form of chemicals, fumes and UV rays from the sun (which is why sunglasses are so important!)
• Dry eyes – if the eye cannot maintain a protective layer of tears and oily substances across the eye, it can become inflamed
• Viruses – one of the common viral causes of keratitis is the herpes simplex virus. This type of keratitis tends to be severe, with herpes simplex being the leading cause of corneal blindness in developed countries, responsible for 1 in 10 corneal transplants
• Bacteria – Staphylococci, Haemophilus and Streptococci are all common causes of bacterial keratitis. Before the development of effective antibiotics, Syphilis was also a common cause
• Occasionally fungal infections can cause keratitis
• Contact lens wear can sometimes cause keratitis, especially if not cleaned properly and replaced often enough as this can cause infections. Poor makeup hygiene can likewise provide an easy route for infection
• Eyelash or eyelid disorders can also sometimes result in keratitis – for example if your eyelids and eyelashes curve in then they can rub against and irritate the cornea, causing the inflammation that defines keratitis.

What are the complications of keratitis?

Complications with keratitis are more likely when the inflammation is deeper in the cornea (stromal keratitis), or when caused by the Herpes Simplex virus. If left untreated, keratitis can cause:

• Ulcerations (corneal ulcers)
• Swelling and scarring of the cornea   
• Temporary of permanent deterioration of vision
• Blindness.

How is keratitis diagnosed?

To diagnose keratitis you will need to visit your GP or eye specialist. They can diagnose keratitis in a number of ways:

• Using a simple eye exam, they will assess the quality of your vision to detect any problems
• They may check your pupils’ reactions to light using a penlight exam
• A slit-light exam uses a narrow beam of light to inspect the different elements of your eye to identify any problems with your cornea that will confirm keratitis
• They may also take a tear sample, or a sample of corneal cells to analyse in a lab to find out the cause of the keratitis, and the treatment that should be used.

What are the treatments for kertitis?

Treatment for keratitis depends on the cause.

Infective keratitis can be treated with antibiotics, antivirals and antifungals. Eye drops may be prescribed if the eyes are particularly dry. Steroid drops may also be prescribed in some cases to reduce inflammation and scarring.

Some kinds of keratitis may not need treating, but that is really up to your doctor to decide.In some cases, if left untreated, keratitis can cause serious damage to vision so it is best to seek medical advice even if you don’t think your keratitis is severe.

In extreme cases a corneal transplant may be necessary, if the keratitis does not respond to treatment.

Self-care

Keratitis can be a serious condition. If you think you have keratitis you should seek medical advice right away to determine the severity of your condition. You should not rely on self-care until you have been advised to do so by your GP.

There are a few measures you can take to relieve some of the symptoms of keratitis, or to prevent the condition starting in the first place:

• Warm and cold compresses can be useful for relieving irritation and discomfort in the eye. Simply soak a flannel in sterile warm (not hot!) or cold water, depending on what feels best, and place over the eyes for 5-10 minutes. This can also help loosen discharge
• Use eye drops to lubricate dry, irritated eyes
• Maintain good eye hygiene by washing your hands before touching your eye or the area around the eye
• Remove make up before going to bed, or as soon as you don’t need to be wearing it any more. Remember to check to use-by dates on your makeup, and don’t share makeup!
• Follow correct cleaning procedures for contact lens wear, and try to take them out if you don’t need them – you could always switch to glasses in the evening while watching TV or having dinner
• Diet is an important part of eye health, so have a look at our hints and tips on good foods for healthy eyes
• If you have a cold sore, avoid touching either the sore or your eye to prevent the virus from spreading into your eyes and causing viral keratitis
• If you experience any eye conditions such as conjunctivitis, try to treat them as quickly as possible to stop them developing into anything more serious.

Are there any herbal remedies that can help?

Keratitis can be a serious medical condition. If you suspect you have keratitis, you should seek medical advice right away to determine the severity of your symptoms.

However, you can use herbal remedies to promote good eye health, to relieve some of the symptoms of keratitis.

The herb Euphrasia is great for eye health; it has been used for hundreds of years to treat eye problems, earning its alternative name, ‘Eyebright’. We recommend using Euphrasia in eye drop form, such as the A.Vogel Eye Drops. These help ease eye problems such as dry, tired or irritated eyes, that may accompany keratitis.

In addition, you could try Vision Complex which promotes healthy eyes and vision because it contains lutein and zinc, which are both essential to maintaining eye health.