Keratitis

Keratitis is an inflammation of the cornea. The cornea is the transparent, dome-shaped tissue at the front of your eye that allows light to pass through and helps you to focus. When this tissue becomes inflamed, it can lead to redness, pain, sensitivity to light, blurred vision and a sensation as if there is something in your eye.

There are various forms of keratitis, depending on the cause. The most common are:

• Infectious keratitis: caused by bacteria, viruses, fungi or parasites such as Acanthamoeba. This form often develops following an injury, due to poorly maintained contact lenses or as a result of swimming whilst wearing lenses.
• Non-infectious keratitis: can be caused by a scratch, dry eyes, an autoimmune reaction, prolonged exposure to UV light or wearing contact lenses for too long.

Keratitis is a serious condition that can quickly worsen. Without treatment, it can lead to permanent damage to the cornea and reduced vision. Infectious keratitis, in particular, requires urgent medical attention.

Contact lens wearers are at increased risk of keratitis, particularly when lenses are not worn or cleaned in accordance with the instructions for use, when lenses are worn for too long, or when swimming or showering whilst wearing lenses. Acanthamoeba keratitis occurs mainly in contact lens wearers and is difficult to treat.

Symptoms and complaints

Keratitis can manifest in various ways. Common symptoms include:

• Pain or a burning sensation in the eye
• Redness and an irritated eye
• Excessive tearing or, conversely, a dry sensation
• Light sensitivity (photophobia)
• Blurred or impaired vision
• A sensation as if there is something in your eye
• Finding it hard to keep your eye open
• Discharge or pus from the eye

If you recognise one or more of these symptoms, please contact your optician, optometrist or ophthalmologist immediately. Keratitis can worsen rapidly and requires prompt assessment.

Causes and risk factors

Keratitis can have various causes. Infectious keratitis is caused by micro-organisms that penetrate the cornea, often via a small scratch or injury. Risk factors include:

• Wearing contact lenses, particularly if they are not looked after properly, worn for too long, worn whilst sleeping or worn whilst swimming
• An injury or scratch to the cornea
• A weakened immune system
• The long-term use of corticosteroid eye drops
• Dry eyes or an eyelid condition that prevents the eye from being properly protected

Non-infectious keratitis can be caused by mechanical irritation, UV radiation (for example, from welding without protection), severe dry eye or an autoimmune reaction.

Diagnosis and treatment

Keratitis is diagnosed by an ophthalmologist or optometrist, usually using a slit lamp. Sometimes a swab or culture is taken to determine the exact cause, particularly if an infection is suspected.

Treatment depends on the cause. Infectious keratitis is treated with antibiotic, antiviral or antifungal eye drops, sometimes in combination with other medication. In cases of non-infectious keratitis, the ophthalmologist determines the treatment depending on the cause. In severe cases, hospitalisation or even a corneal transplant may be necessary.

If you have any symptoms or are unsure, please have them assessed by your optician, optometrist or ophthalmologist. Keratitis is a medical condition that requires professional care.