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Keratitis

Keratitis is the general term for inflammation of the cornea. It can either be infectious or non-infectious. Bacteria, fungi and viruses are some of the more common causes of infectious keratitis.

  1. Inflammation of the cornea
  2. Often causes intense pain
  3. Treated with eye drops

It’s best to seek medical advice right away if you think you may have keratitis. If you are concerned about the condition and want to talk to a doctor about keratitis online, book an appointment through our video consultation service. Our GMC-registered practitioners work around your timetable. Choose a slot at a time that suits you best.

Keratitis
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Description

Keratitis is characterised by inflammation of the cornea, and can be the result of either an infection or an injury (such as a scratch on the eye from a contact lense). Possible symptoms include redness and swelling in the eye, discharge, and inhibited or blurred vision. You should speak to a doctor as soon as possible if you think you might have keratitis, or are developing eye symptoms.

Infectious cases of keratitis can be caused by bacteria, a virus, fungus, or a parasite. The most common trigger is the herpes simplex virus, but keratitis can also result from a foreign object touching the eye, and as a consequence of vitamin A deficiency. In viral cases, a weakened immune system can often be a factor. 

Bacteria that may lead to keratitis include staphylococci, streptococci and haemophilus. If bacteria somehow come into contact with the cornea (for example, if someone has the bacteria on their fingers and they rub their eyes) these pathogens can then grow and multiply.

Aspergillus, nocardia and candida are the most likely fungi to cause fungal keratitis. This can occur when the fungi come into contact with the cornea and begin to spread. Someone who works with plants or crops may be susceptible to this type of keratitis, as debris can break off and land in the eye.

There are measures you can take to prevent keratitis. For example, changing contact lenses daily and cleaning them with sterile fluid can lower the risk of bacteria entering the eye. You should also avoid touching your eye if you have dirty or soiled hands. Wearing eye protection if you work with plants outdoors is another way of preventing an infection.

Keratitis usually causes pain in the eye and redness. It can often result in blurry vision and the feeling that something is in the eye pressing against it. Keratitis may also trigger excessive tears, as well as an uncomfortable sensitivity to light. 

It’s important to seek medical advice as soon as possible if you have pain or signs of inflammation in the eye. Complications of keratitis can be very severe if the infection spreads to deeper layers of the cornea. Deeper infection can lead to a corneal ulcer or a scar, which can affect vision and even lead to blindness in the most severe cases. 

Our video-based doctors are available to talk to online about keratitis if you are concerned. They will be able to provide advice on symptoms, and advise you on what to do next. Click below to book an appointment at a convenient time for you.

Page last reviewed:  29/04/2020
Diagnosis and treatment

How is keratitis diagnosed?

Keratitis is usually diagnosed after examination by a doctor. The examination will involve a slit-lamp which emits a narrow beam through the centre of the eye to illuminate the cornea. It will show what effect keratitis has had on the surface of the eye, and how far it has spread.

Will I need tests?

It's possible that if a diagnosis cannot accurately be made from an examination, your doctor may decide to take a sample from your cornea to be analysed in a laboratory. This procedure is more likely if infectious keratitis is suspected.

What will a doctor normally advise?

Specialist treatment will normally be required. A doctor will usually recommend some form of medication for your eye, especially if it's infectious. Left untreated, keratitis can cause permanent damage and sight loss.

If keratitis has been caused by an injury, a doctor may just advise using an eye patch to cover the eye and allowing it to heal. If you use contact lenses, a doctor will advise you to stop using them until the keratitis clears. 

What treatments are there for keratitis?

It depends on what type of keratitis is present. It can be caused by bacterial, viral or fungal infections. 

For bacterial keratitis, in most cases antibacterial eye drops, along with quinolone antibiotics, clear the infection. 

Fungal keratitis will usually require a combination of antifungal eye drops and oral medication. 

Antiviral medicines such as aciclovir may be advised if the infection is caused by a virus, such as herpes simplex.

Page last reviewed:  29/04/2020
Questions and Answers

How is keratitis treated?

It depends on the cause. The condition usually requires assessment from a specialist. Eye drops are the most common form of treatment, but the type you are issued with will be based on whether an infection is present, and if so, what type of infection.

Very rarely, steroid eye drops may also be used to reduce inflammation or scarring if it has already occurred.

Keratitis that is caused by an injury, rather than an infection, may resolve without specific treatment.

What treatments are there?

Antibiotics, antifungals and antivirals are all available as eye drops or as oral medications. A doctor may suggest using eye drops, or a combination of eye drops and oral tablets in more serious cases. 

Are there side effects?

The most commonly reported side effects of eye drop solutions for keratitis are a stinging feeling on first application, and temporary, blurred vision. Rare side effects include a rash or severe swelling around the eyes.

Can I consult a doctor about keratitis online?

Keratitis can be a serious condition, and may necessitate specialist treatment. You should see a doctor as soon as you can if you think you may have keratitis.

If you have symptoms of keratitis, such as eye inflammation or pain in the eye, and are unable for any reason to see a doctor in person, you can consult with one of our doctors online. It is however very likely that you will need to be seen in person in a specialist eye clinic if keratitis is suspected. They will be able to advise you on what you should do, and whether specialist treatment is necessary. 

Our doctors can make referrals and issue prescriptions where appropriate. Book a slot with a prescriber at a time that suits you best.

Page last reviewed:  29/04/2020

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