What is it
Keratitis
Keratitis is an inflammation of the outer layer of the cornea, a structure that lines the front of the eye and is part of the ocular surface. Like the crystalline lens, it is characterized by its transparency and because it is part of the ocular focusing system.
Keratitis often affects only the corneal epithelium, which is the outer part of the cornea, and usually heals without major complications. On the other hand, cases in which the deeper layers are damaged are more serious, although their incidence is lower.
The origin of keratitis is multiple. Among the most common causes are dry eyes (dry eye syndrome can cause superficial lesions on the cornea), viral infections (herpetic keratitis and keratoconjunctivitis) or bacterial infections (bacterial keratitis). The latter, due to their potential severity (they can evolve very aggressively), require a rapid diagnosis.
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Other factors that influence keratitis are irritating and/or toxic substances that come into contact with the eye, allergic processes or abnormal closing of the eyelids, which leads to exposure keratitis.
Keratitis causes pain, tearing and intense photophobia in the patient. Depending on the affected area, it can also cause a significant decrease in visual acuity.
Prevention
The best way to prevent keratitis is to properly combat those circumstances that influence its appearance. In the case of dry eye disease, it is advisable to use artificial tears, and to protect yourself from the intense sun, it is advisable to wear approved glasses. As for allergy sufferers, it is important that they avoid contact with the triggers of their allergy (pollens, mites, dust).
For regular contact lens wearers who also use them intensively, it is necessary to maintain meticulous hygiene and replace them frequently. It should be borne in mind that they are much more exposed to corneal infections.
However, at the first manifestations of the symptoms described, the patient should not hesitate to go to the ophthalmologist, since the speed in establishing treatment considerably improves the prognosis of this corneal condition.
Treatment
The treatment of keratitis will depend on the factor that has caused it and should be started as soon as possible to prevent possible scarring of the cornea that leads to a deterioration of vision.
In any form of keratitis, special attention must be paid to those cases in which the deeper layers of the cornea are affected, since there could be a scar that could potentially affect vision, depending on the place where it is located.
The types of keratitis are:
- Keratitis of allergic origin: they require treatment based on topical anti-allergic drugs.
- Bacterial keratitis: results from an infection from the use of contact lenses or a previous injury to the cornea, among other causes. They progress rapidly to the point of leading to blindness if left untreated. The indicated treatment is antibiotic eye drops.
- Viral keratitis: These are usually caused by the herpes simplex virus (herpetic keratitis) or adenovirus (keratoconjunctivitis).
In the case of herpetic keratitis, milder infections are usually treated with ophthalmic ointments with or without anti-inflammatories, which can sometimes be associated with the administration of oral antivirals.
Keratoconjunctivitis is a very contagious form of keratitis, which the specialist will treat with antivirals and anti-inflammatories.
When the disease process worsens, producing corneal scarring and a significant decrease in vision, corneal transplantation is the most appropriate option. To prevent the virus from becoming active again, as it is still in the neuronal ganglion, an anti-virus is administered orally as a prophylactic measure for the first year.
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