Keratitis

Diagnosis

Diagnosing keratitis usually involves several eye examinations to determine the cause and severity of the condition.

• Eye exam to check the surface and overall health of the eye, even if opening the eyes feels uncomfortable.

• Penlight exam to observe pupil size, reaction and surface changes. A special dye may be applied to highlight corneal damage.

• Slit-lamp exam using a bright light and magnification to see details of the cornea and surrounding structures.

• Laboratory analysis of tear samples or corneal cells to identify the exact cause and guide treatment.

Treatment

Treatment for keratitis depends on whether the condition is infectious or noninfectious.

Noninfectious keratitis

Treatment varies based on severity. Mild symptoms from a corneal scratch may improve with artificial tears. More severe cases involving pain and excessive tearing may require prescription eye medications.

Infectious keratitis

The treatment approach depends on the organism responsible for the infection.

• Bacterial keratitis treated with antibiotic eye drops. Frequency may range from several times daily to every 30 minutes, including nighttime doses. In some cases, oral antibiotics are added.

• Fungal keratitis treated with antifungal eye drops along with oral antifungal medicine.

• Viral keratitis managed with antiviral eye drops and oral antiviral medications. Some viral infections need only supportive care such as artificial tears.

• Acanthamoeba keratitis treated with antiparasitic eye drops. Some infections resist treatment and may require several months of therapy. Severe cases may need a cornea transplant.

If medication does not improve keratitis, or if corneal damage leads to significant vision loss, a cornea transplant may be recommended.