Types and Treatments of Keratitis | Ophthalmology


What is keratitis?

Keratitis is a painful inflammation of the eye. It can be caused by infection or injury. There are many types of keratitis, and each type requires different treatment. If you have red eyes or other symptoms of keratitis, make an appointment with your doctor. With immediate care, mild to moderate cases of keratitis can usually be treated effectively without losing vision. If left untreated, or if the infection is severe, this can lead to serious complications that can permanently damage your vision.

The eye is very sensitive and there are many ways to protect it from damage. The eyelid covers the eye and protects against tears and fluid infection. The cornea is the outer layer of the eye and provides a barrier against dust, germs, and disease. Keratitis is a common condition. People who wear contact lenses experience keratitis more often than people who do not wear contact lenses. In both cases, you can take steps to prevent this situation. If you develop keratitis, see your doctor immediately.

Types of keratitis

There are two main types of keratitis, depending on the cause. Keratitis can be classified as infectious or contagious.

Infectious keratitis

Infectious keratitis is caused by one of the following:

  • Bacteria: Pseudomonas aeruginosa and Staphylococcus aureus are the two most common bacteria that cause this disease. It is more likely to develop in people who do not use contacts correctly.
  • Fungi: Fungal keratitis is caused by Aspergillus, Candida, or Fusarium. Like bacterial keratitis, fungal keratitis primarily affects contact lens wearers. However, it is possible to expose these fungi outside.
  • Parasites: Acanthumoba is the most common contact lens wearer in the United States. The parasite lives outside and can be contracted by swimming in a lake, walking through the woods, or getting infected water on your contact lenses. This type of infection is called acanthoma keratitis.
  • Viruses: Viral keratitis is mainly caused by the herpes simplex virus, which grows from conjunctivitis to this disease.

Non-infectious keratitis


  • Like eye injuries, scratches
  • Your contact lenses will wear out too long
  • Wearing extended clothing contacts
  • Wear your contact lenses while swimming
  • Living in a hot climate increases the risk of plant substances damaging the cornea
  • Weakened immune system
  • Exposure to strong sunlight, also known as photokeratitis

Keratitis symptoms

  • Red eyes
  • Pain and irritation in the affected eye.
  • Vision changes, such as blurred vision or inability to see
  • Sensitivity to light
  • Inability to open the eye
  • Eye discharge
  • Excessive tearing

Without treatment, the symptoms of this disease can progress and get worse. Depending on the type, when symptoms appear. For example, symptoms of bacterial keratitis appear immediately.

Causes of keratitis

  • Injury: Most of the time, it comes from damaging the cornea. You may have pierced your eye or scratched your eye with your finger. This can happen even if you wear your contact lenses for a long time or wear lenses that don’t fit well. The wound can cause inflammation, but it can also allow bacteria or fungi to cause an infection.
  • Viral infection: It is usually caused by herpes simplex, chickenpox virus, or a cold. If you are sick, be careful not to touch your eyes and keep your hands clean.
  • Bacterial infections: This is less common, but can be a problem for people who wear contact lenses. Bacteria can grow on your contact lenses or your contact case if you don’t clean and store them properly. Extended wear lenses can lead to you sleeping for days or weeks at a time. Infection can also come from contaminated eye drops or contact solutions. Or it can happen after eye surgery.
  • Parasite: Acanthumoba is a microbe that lives everywhere: in the air, soil, and bodies of water. It is also found in tap water. It is harmless most of the time. But it can also cause an eye infection, especially if you wear contact lenses. It is very rare, but also very difficult to treat.
  • Yeast: It is also very rare for you to get a yeast infection in your eye. It usually comes from scratches on the eyes or contacts contaminated by a branch. Eye surgery can also cause this.
  • Other causes: Vitamin A deficiency, some diseases that are a problem for your immune system, and diseases that cause very dry eyes can lead to this.

Risk factors for keratitis

  • Put glasses on the surface of the eye. Wearing contact lenses, especially sleeping glasses, increases the risk of infectious and non-infectious keratitis. The risk is wearing contact lenses for longer than recommended, improper disinfection, or swimming.
  • It is more common in people who wear long-wear contact lenses or who wear contact lenses continuously than in those who wear contact lenses for daily wear and take them out at night.
  • Decreased immunity If your immune system is compromised by illness or medication, you are at risk of developing this disease.
  • Corticosteroids Using corticosteroid drops to treat an eye disorder may increase the risk of infectious keratitis.
  • Eye wound. If one of your corneas has been damaged by an injury in the past, you are more likely to develop this disease.

Diagnosis of keratitis

The diagnosis generally includes the following:

  • Vision test: Although it may be uncomfortable to open your eyes for a test, it is important to have your eyes examined by your doctor. The test involves how well you can see (visual acuity).
  • Penelope test: Your doctor may examine your eye with penicillin to check your student’s reaction, size, and other factors. Your doctor may apply the stain to the surface of your eye to help determine the extent and symptoms of corneal ulcers and surface manipulations.
  • Slit-lamp test: Your doctor will examine your eyes with a special device called a slit lamp. Provides a bright light source and magnification to determine the role and extent of this disease, as well as its effect on other structures in the eye.
  • Laboratory analysis: Your doctor may take a sample of the tear or some cells from your cornea for lab tests to help determine the cause of this disease and develop a treatment plan for your condition.

Keratitis treatment

If a person has this disease and wears contact lenses, they should be removed as soon as they develop any symptoms of infection or irritation. Contact lenses should not be reused until the condition clears. If a person has mild bacterial keratitis, the doctor may recommend that they use antibacterial eye drops.

In more serious cases, the person may need antibiotics. Steroid eye drops reduce inflammation if it is particularly severe. People can apply eye drops at home and should use them regularly. As the condition improves, people may use medications less often.

People with fungal keratitis may need to use antifungal medications for a few months. If this does not resolve the condition, surgery may be necessary in severe cases. Eye drops or antiviral medications are used to treat viral keratitis. Since there is no cure for the herpes simplex virus that causes viral keratitis, this condition can recur.

Parasitic keratitis is a very difficult type to treat and requires emergency medical treatment and surgery. During treatment, anyone should consult an ophthalmologist:

  • The condition does not improve with the use of eye drops.
  • Your vision becomes blurry
  • The eye becomes more painful or red
  • The size of the white spot on the cornea increases.


  • Chronic corneal inflammation and scars.
  • Chronic or recurrent viral infection of your cornea
  • Open sores on the cornea (corneal ulcer)
  • Temporary or permanent reduction in your vision.
  • Blindness

 Prevention of keratitis

If you wear contact lenses, proper wear, cleaning, and disinfection can help prevent this disease. Follow these tips:

  • Choose contact lenses for daily use and remove them before bed.
  • Wash, rinse, and dry your hands well before handling your contact lenses.
  • Follow the recommendations of your eye care professionals for caring for your lenses.
  • Use only clean products made specifically for contact lens care, and use lens care products made for the lenses you wear.
  • Gently rub the lenses during cleaning to increase the cleaning performance of the contact lens solutions. Avoid rough handling that can make your lenses scratch.
  • Replace your contact lenses as recommended.
  • Change your contact lens case every three to six months.
  • Ignore the solution in the contact lens case every time you disinfect your lenses. Do not “fill in” an existing old solution.
  • Do not wear contact lenses when you go swimming.
  • Prevent the spread of the virus.

Some forms of viral keratitis are not eliminated. But the following steps can control the incidence of viral keratitis:

  • If you have a cold sore or herpes blister, avoid touching your eyes, eyelids, and the skin around your eyes, unless you wash your hands well.
  • Use only eye drops prescribed by an ophthalmologist.
  • Washing your hands frequently can spread the virus.
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