Keratitis in adults

Keratitis in certain cases can lead to serious complications, up to clouding of the cornea and a sharp decrease in vision, which is then very difficult to correct. Therefore, you need to consult a doctor at the first symptoms.

What is keratitis

Keratitis is an inflammatory process in the cornea. The cornea is a thin and completely transparent tissue that forms a convex hemisphere in front of the eyeball. It has a light-refracting optical medium that conducts light rays into the pupil.

What you need to know about keratitis

Causes of keratitis in adults

Most often, keratitis occurs as a result of a viral infection. Up to 70% of inflammations are provoked by herpes viruses – simple or causing chicken pox and shingles. In addition, keratitis can occur with adenovirus infection, measles.

Also, keratitis can provoke pathogenic bacteria. There are two types of inflammation:

• non-specific – caused by pneumococci, staphylococci, streptococci, Pseudomonas aeruginosa, diplococci, Klebsiella, Escherichia coli or Proteus;
• specific is the defeat of tuberculosis bacteria, salmonella, malaria, syphilis, gonorrhea, diphtheria, chlamydia, brucellosis.

Extremely severe keratitis occurs when infected with an amoebic infection (Acanthamoeba). This is possible in people who wear lenses, divers, patients with eye problems.

Fungal keratitis is rare. Keratomycosis provoke fusarium, candidiasis or aspergillosis.

Keratitis is possible with allergies (especially against the background of hay fever), as a side effect of taking certain drugs, in the presence of worms, allergies to food or household chemicals.

There are also immuno-inflammatory forms of keratitis that occur with certain diseases – this is Sjögren’s syndrome, rheumatoid arthritis, nodular arteritis. If a person is exposed to intense ultraviolet radiation, photokeratitis is possible.

Most often, keratitis occurs as a consequence of eye injuries – temperature, mechanical or chemical. Sometimes it occurs as a complication of eye surgery, or logophthalmos (impossibility of complete closure of the eyelids), inflammation of the eyelid, conjunctivitis, dacryocystitis, lesions of the sebaceous glands on the eyelids. Often keratitis complicates the misuse of contact lenses.

Risk factors in the development of keratitis can be malnutrition, lack of vitamins, reduced immunity, diabetes, or gout.

Symptoms of keratitis in adults

The most typical manifestation, which is characteristic of all variants of keratitis, is corneal syndrome. It:

• sharp pain in the eye;
• intolerance to light – daylight or artificial;
• lacrimation;
• reflex spasm of the eyelids;
• decreased vision;
• sensation of a foreign object under the eyelid;
• redness of the eyeball.

All these symptoms are associated with irritation of the nerve endings by the inflammatory process. In addition, due to swelling and penetration of cells and fluid into the area of ​​inflammation, the cornea loses its transparency, luster, turbidity occurs, the sensitivity and shape of the cornea suffer. Sometimes keratitis may not have a pronounced corneal syndrome, the sensitivity is reduced.

The infiltrate may look like a gray or yellow spot on the cornea, which forms its clouding, which reduces visual acuity.

The most dangerous option for the development of keratitis is the formation of an ulcer. First, surface erosion is formed, then it deepens, a defect with a cloudy gray coating is formed. In the future, a thorn may form.

Often, keratitis occurs along with conjunctivitis, uveitis, iridocyclitis. If the inflammation is purulent, the eye may die.

Treatment of keratitis in adults

Keratitis is dangerous for its complications, which lead to a sharp decrease in vision. Therefore, it is important to identify it and treat it as soon as possible. This is necessary to prevent the formation of ulcers, thorns and the transfer of infection to neighboring departments.

Diagnostics

It is important to tell the doctor about recent diseases, eye trauma, viral infections, inflammation of other organs. The doctor conducts an eye examination with an assessment of the corneal syndrome and the severity of local changes.

For diagnosis, biomicroscopy of the eye is used – a doctor using a magnifying device finds and evaluates a corneal injury. The thickness of the stratum corneum is measured using ultrasonic pachymetry or optical. The doctor also performs confocal and endothelial microscopy in the cornea, studies its curvature during computer keratometry, and evaluates refraction during keratotopography. The ophthalmologist also evaluates the corneal reflex using a corneal sensitivity test or esthesiometry.

An installation test with a fluorescent substance helps to determine erosion or ulcers. It is also important to determine the causative agent of inflammation – they carry out crops from the edges and bottom of ulcerative defects, conduct PCR tests and ELISA tests. Allergy testing may be needed.

Modern treatments

Often there is a need to prescribe antibacterial, antiviral and anti-inflammatory drugs inside for a long time.

On average, uncomplicated forms of keratitis can be treated for up to 2 to 4 weeks, with an individual selection of therapy that will be most effective in each case.

Preparations for keratitis

Viral keratitis to suppress infection requires the use of interferon or Acyclovir. It may be necessary to use ointments – florenal, bonafton, with acyclovir, tebrofen. Supplement the treatment with oral preparations to stimulate immunity – Levamisole, thymus preparations.

Bacterial keratitis is treated with antibiotics in the form of drops, injections into the eye area, or ingestion (penicillins, fluoroquinolones, aminoglycosides).

Allergic keratitis is treated with the appointment of antihistamines (Suprastin, Xyzal, Cetrin, Zirtek) with the use of local hormonal drugs.

Mydriatics are also used – dilating the pupil (atropine, scopolamine), healing drops and ointments with taurine.

Prevention of keratitis in adults at home

– For the prevention of keratitis, it is necessary to follow the rules of personal hygiene, advises ophthalmologist Oksana Levkina, – treat conjunctivitis in time, be especially scrupulous in observing the rules for wearing contact lenses and, at the slightest suspicion of the development of inflammation, contact an ophthalmologist.

Popular questions and answers

We discussed with ophthalmologist Oksana Levkina possible complications of keratitis and clarified whether this disease can be cured at home, folk methods.