Keratitis and what you need to know

Keratitis is a dangerous disease and can lead to blindness. However, patients can treat and recover well if diagnosed and treated early. Therefore, it is important to understand the signs of suspected illness and to seek medical attention promptly to prevent future serious consequences. In this article, we will cover what you need to know about keratitis.

1. What is cornea?

The cornea is a thin, transparent membrane located in front of the eye. It allows light to pass through, helping us see. In addition, the cornea also plays an important role in regulating and protecting the eyes from pathogens (dirt, bacteria, viruses …).

2. What is keratitis?

Keratitis is an inflammation of the dome pattern on the front of the eye that covers the pupils and iris. The disease may or may not be related to the infection. Non-infectious keratitis may be caused by a relatively minor injury, such as a fingernail tip, or from very long or contaminated lenses. Infectious diseases can be caused by bacteria, viruses, fungi and parasites.

If redness or other symptoms of the disease, make an appointment to see a doctor. With prompt, mild to moderate attention, cases of keratitis can often be achieved with no loss of vision. If left untreated, or if the infection is severe, keratitis can lead to serious complications that can permanently damage vision.

3. Classification of keratitis

The disease may be caused by infection or non-infection, causing an inflammatory reaction without pus, pus or death. Keratitis may be superficial (corneal epithelium) or deep keratitis (corneal parenchyma).

Dermatitis epithelial keratitis

Common in metastatic conjunctivitis, caused by herpes simplex, Thygeson superficial keratitis.

Parenchymal keratitis

– Non-purulent parenchymal keratitis: manifests itself in a gray-gray stained body of polymorphonuclear leukocytes, which may not be necrotic or gangrene

+ Discular keratitis: is a edematous lesion caused by necrotizing parenchyma

+ Inflammation of the parenchyma pattern: Expresses an immune loop in the corneal parenchyma (wessely), with an image similar to an antigen-antibody reaction on the test.

+ Interstitial keratitis IK (Interstitial keratitis IK): is a non-purulent inflammation (cell infiltration and often new vessels) of the corneal parenchyma without the primary damage to the epithelium or endothelium. IK parenchymal keratitis is largely due to the immune response to infectious agents or their antigens in the corneal parenchyma.

Common causes of non-purulent parenchyma keratitis: syphilis of syphilis caused by syphilis, herpes simplex, varicella-zoster keratitis, tuberculosis.

Other causes of IK include: Mycobacterium leprae, Lyme disease, measles (Rubeon), infectious mononucleosis, venereal seed lymphoma.

+ Acute parenchymal keratitis: is caused by the direct destruction of corneal cells accompanied by degeneration of parenchymal leaves and can progress to purulent inflammation.

– Purulent parenchymal keratitis: manifested as a neutrophilic leukocytosis, the foci of infection are yellow, surrounded by inflamed cells and edema.

Peripheral keratitis

Peripheral keratitis is a manifestation of the pathological process of the central cornea and the changes caused by eye and systemic disease. Connective tissue diseases and autoimmune diseases can cause ulceration and peripheral corneal thinning.

Superficial keratitis

Superficial keratitis is mainly caused by virus: herpes, shingles or other viruses (adenovirus, fibrous …)

The disease can also occur in acute or chronic diseases of the eyelid and conjunctiva such as disturbance of the secretion of tears (dry eyes), open eyelids, intoxication.

4. The main cause of disease

There are many possible causes of keratitis, namely:

  • Injury: An inflammatory reaction occurs when the cornea is injured or scratched by an object (usually by contact lenses). Microorganisms can also through the wounds penetrate the cornea, making the condition worse.
  • Infections: Possible agents are bacteria, viruses, parasites, fungi, etc. The disease usually occurs in people who use improper contact lenses. Through this, microorganisms will grow on the surface of the glass and cause an infection in the cornea.
  • Other causes: Vitamin A deficiency, immunodeficiency diseases (HIV / AIDS …), persistent dry eyes … can also lead to keratitis.

5. Symptoms of keratitis

The following are signs of suspected keratitis:

  • Eyesore.
  • Red eyes.
  • Irritability, feeling of something foreign in the eye or a burning sensation
  • Glare, fear of light.
  • There is a lot of tears, or there is yellow or white in the eyes.
  • Swelling of eyelids, even difficult to open.
  • Blurred vision.

You need to quickly go to the eye clinic or eye specialist hospital for timely detection. Delays in diagnosis and treatment can lead to serious complications, including permanent vision loss.

6. How is keratitis treated?

Depending on the cause of the keratitis, treatments may vary, including medication and surgery.

In the non-infectious group, keratitis is usually self-limiting when the eye lesions recover. Treatment is aimed at reducing symptoms and preventing newly developing infections.

In contrast, for the group of causes due to infection, treatment will vary according to the causative agent, namely:

  • Bacterial agent: For mild keratitis, antibiotics are usually only required in the form of eye drops. However, moderate and severe levels may require oral antibiotics.
  • Viral agents: Treatment may be oral antiviral drugs, eye drops or symptomatic treatment (depending on the type of virus causing the disease).
  • The agent is a parasite: Among the parasites that cause disease, Acanthamoeba is the agent that causes the most difficulty in treating because of its resistance to drugs. Some severe cases may require corneal replacement.
  • Fungal agents: Oral and ophthalmic antifungal agents are often used in combination.

Manifestations of keratitis are quite diverse including sore eyes, red eyes, watery eyes, etc. Treatment may be medication or surgery depending on the severity of the disease. It is very important to follow all precautions as advised by your doctor. Delays in diagnosis can lead to later sequelae. Therefore, if there are any signs of doubt, please see a doctor to be detected and treated early!


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