• Infections

A Complete Guide to Keratitis: Symptoms, Treatments, and Prevention

Eye pain, redness, blurred vision, and corneal swelling are all signs of keratitis, which can lead to serious complications if left untreated. 

Keratitis can result from infections and injuries, making it important to recognize the symptoms and seek early medical treatment. 

Whether you wear contact lenses, have experienced eye trauma, or are interested in maintaining good eye health, understanding keratitis is crucial for protecting your vision.

In this article, we’ll discuss the main causes and symptoms of keratitis should you be worried about this condition. We’ll also share how you can prevent developing keratitis.

What is Keratitis?

Keratitis is an inflammation of the cornea, which is the clear, dome-shaped surface covering the front of the eye. 

The cornea plays a crucial role in focusing vision and protecting the eye from dirt, germs, and other particles. Inflammation of the cornea can disrupt its normal function and lead to various symptoms.

There are two types of keratitis:

• Infectious keratitis: When keratitis is caused by a bacterial, viral, or fungal infection, it’s called infectious keratitis. We’ll explain later in this article how each type of infectious keratitis is treated.

• Noninfectious keratitis: People can also develop noninfectious keratitis, which is when the condition isn’t caused by bacteria but rather injury or trauma to the eye. 

What Causes Keratitis? 

Keratitis can be caused by a number of different factors, including:

Injury

Small objects and debris might injure the surface of the cornea, causing noninfectious keratitis. Injuries may allow microorganisms to access the damaged cornea, causing infectious keratitis.

Viruses, fungi, and parasites

These organisms can live on the surface of a contact lens or its carrying case. While the lens is in the eye, the cornea can become contaminated, causing an infection. 

Using contact lenses for too long or not cleaning them properly can also cause injury to the cornea and lead to infectious keratitis.

Certain viruses, such as herpes simplex virus, may cause keratitis. Bacteria like streptococcus and pseudomonas are also common causes of keratitis. 

Spending time in water, such as oceans, rivers, lakes, and hot tubs, can all cause bacteria, fungi, and parasites to enter the eyes. 

This can result in keratitis, although a healthy cornea acts as a barrier and shouldn’t become infected unless the surface has been damaged in some way.

Not cleaning or storing contact lenses correctly can lead to bacterial contamination. As mentioned above, these bacteria can adhere to the surfaces of contact lenses and cause bacterial keratitis. 

Symptoms of Keratitis

There are several signs of keratitis that you may experience. Symptoms of keratitis include:

Eye redness

With keratitis, the cornea may become damaged, which triggers an inflammatory response, resulting in redness and eye irritation.

Eye pain

Any damage or trauma to the cornea exposes its underlying nerve endings, which can lead to significant pain.

Excess tears or discharge

The cornea contains many sensory nerves. When it becomes inflamed or irritated, these nerves are stimulated, triggering a reflex that increases tear production. This is the body’s natural response to try to wash away irritants or pathogens from the surface of the eye.

Bacterial keratitis often leads to the production of thick, yellow, or green-colored discharge. This discharge consists of dead bacteria and tissue debris. 

The body produces this discharge as part of its immune response to clear an infection.

Blurred vision

Inflammation of the cornea leads to the accumulation of fluid within its layers. This leads to swelling and disrupts the cornea's normal arrangement of collagen fibers, causing it to lose its transparency and resulting in blurred vision. 

Damage to the cornea can also create an irregular surface that scatters light as it enters the eye, making it difficult to see properly.

Decreased vision

When the cornea becomes damaged or infected, the body launches an immune response, during which blood cells enter the corneal tissue. These cells and the inflammation can cloud the cornea and reduce vision.

Sensitivity to light

As mentioned earlier, the cornea contains many sensory nerve endings, making it extremely sensitive. Inflammation or damage to the cornea from keratitis irritates these nerve endings, leading to heightened sensitivity to light.

During keratitis, inflammatory mediators — chemicals such as histamines, prostaglandins, and cytokines — are released into the cornea. 

These chemicals can sensitize the corneal nerves, making them more responsive to light.

Eyelid pain or irritation

The inflammation from keratitis can spread to nearby tissues, including the eyelids, making them inflamed and irritated.

The inflammatory mediators we mentioned above can also affect the tissues around the eye, including the eyelids, causing pain and irritation.

Finally, keratitis can lead to increased blinking in an effort to protect the eyes, as blinking minimizes light exposure and reduces irritation. Frequent blinking can lead to eyelid muscle fatigue and pain.

What Are the Risk Factors for Keratitis?

Some people have a higher risk of developing keratitis. Risk factors include:

Wearing contact lenses

People who wear contact lenses have a higher chance of developing keratitis, especially those who sleep with their contact lenses in. 

Wearing contact lenses increases the risk of both infectious and noninfectious keratitis developing. 

This is especially true if you wear them longer than recommended, don’t disinfect them properly, or wear them while swimming.

A weakened immune system

People with a weakened immune system due to medical conditions or certain medications are more susceptible to infection and risk developing keratitis. 

Using corticosteroid eye drops

Using corticosteroid eye drops to treat an eye disorder can worsen existing keratitis or predispose you to develop infectious keratitis. 

This is because corticosteroids may suppress the body’s immune response, impairing its ability to fight off infections like keratitis.

What Are the Complications of Keratitis

In severe cases of untreated keratitis, the following complications may occur:

• Temporary or permanent vision loss

• An open sore on the cornea — referred to as a corneal ulcer

• Recurrent or chronic viral infections of the cornea

• Chronic corneal scarring and inflammation

How is Keratitis Treated?

If you are experiencing any of the symptoms of keratitis, you must see an eye specialist immediately. 

Delaying medical treatment can lead to serious complications, including blindness in severe cases.

The treatment you receive from an eye specialist will depend on the cause of your keratitis. Keratitis treatment includes:

• Bacterial keratitis: Initial treatment often involves broad-spectrum antibiotic eye drops that target a wide range of bacteria.

• Viral keratitis: Eye drops containing antiviral agents such as ganciclovir or trifluridine are commonly used.

• Fungal keratitis: Eye drops containing antifungal agents like natamycin or voriconazole are commonly prescribed. 

• Parasitic keratitis: Eye drops containing agents like chlorhexidine or polyhexamethylene biguanide (PHMB) are used.

• Noninfectious keratitis: Corticosteroid eye drops are used to reduce inflammation. However, they must be used cautiously as they can worsen certain infections. Ensure you use corticosteroid eye drops exactly as prescribed. 

In severe cases of infectious keratitis, you may also be prescribed oral antibiotics, particularly if the infection has spread beyond the cornea to other parts of the eye, like the conjunctiva, sclera, and eyelids.

You may also be given artificial tears to help relieve symptoms by keeping the eyes moist. Analgesic eye drops or oral pain relievers may be prescribed to manage discomfort.

Steps to Prevent Keratitis

There are some practical steps you can take to ensure you don’t develop keratitis:

• Use sterile solutions: Always use solutions designed for contact lenses to clean, rinse, and store contact lenses. Avoid using tap water or homemade solutions.

• Wash your hands: Wash your hands thoroughly with soap and water before handling your contact lenses.

• Clean lens cases: Regularly clean and replace your contact lens cases. Use sterile solutions to clean them and let the case air dry.

• Avoid overwearing: Don’t wear contact lenses for longer than recommended, and avoid sleeping while wearing them unless designed for overnight use.

• Wear eye protection: Wear protective goggles or glasses when doing activities that could result in eye injury, such as sports, construction work, or handling chemicals.

• Go for regular checkups: Schedule regular eye examinations with an eye care professional to detect and address any issues early on.

• Avoid touching the eyes: To prevent pathogens from entering the eye, try not to touch or rub the eyes excessively, especially with unwashed hands. This is especially important if you have a cold sore or herpes blister. 

Where Can I Learn More about Keratitis?

At LifeMD, you can consult a healthcare professional via telehealth from the comfort of your own home.

You can speak to a board-certified physician or nurse practitioners for medical advice, guidance, and treatment for keratitis and many other conditions.

Licensed healthcare providers can prescribe eye drops and other medications to ensure you protect your vision and recover from keratitis safely and comfortably.

Visit our website to book your online appointment.

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