Keratitis
- Is an inflammation or infection of the cornea that can be caused by a variety of microorganisms.
- When it involves conjunctiva & cornea it is termed as kerato-conjuctivitis.
Bacterial infections
- Epithelial layer can get disrupted & cornea can become infected by a variety of bacteria.
- Risk factors include mechanical or chemical corneal epithelial damage, contact lens wear, debilitation, nutritional deficiencies, immuno suppressed states & contaminated products
- Topical or subconjunctival antibiotics are generally effective, if severe IV antibiotics are used.
Viral infections
- Herpes simplex virus keratitis is most common viral infection of the cornea
- Pain & photophobia may appear
- Therapy- corneal debridement
- Topical therapy with vidarabine or trifluridine is beneficial
- Oral acyclovir
Keratoconjunctivitis is the most serious ocular adenoviral disease.
- Spread by direct contact, including sexual activity
- Patient may complain of tearing, redness, photophobia & foreign body sensation.
- Treatment is with topical corticoSteroids & antibiotic ointment Teaching about good hygienic practices
Corneal ulcer
- Tissue loss caused by infection of the cornea produces a corneal ulcer (infectious keratitis)
- Infection can be due to bacteria, fungi & viruses.
- Painful & patient may feel a foreign body in the eye, tearing , purulent or watery discharge, redness & photophobia
- Treatment-antibiotic, antiviral or other antifungal eye drops.
- Untreated corneal ulcer can result in corneal scarring & perforation
Leukoma
- Means opacity of the cornea affecting. small area or whole of the cornea.
Causes
- Healed corneal ulcer
- Healed keratitis
- Penetrative or operative injury to the cornea
- Foreign bodies or corneal dystrophy
Symptoms
- No symptoms if the opacity is outside the pupillary area
- Visual disturbances — if it is in the pupillary area
Management
- Small, does not hamper the vision- no treatment required.
- If hampers vision-
- Keratoplasty/ corneal grafting
- Optical iridectomy- pupillary area is extended to periphery by making a complete iridectomy followed by cosmetic surgery
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