Eye Keratitis

Eye Keratitis: Description, Causes and Risk Factors:Alternative Names: Corneal ulcer, eye herpes, ocular herpes, eye shingles.Eye KeratitisEye keratitis (eye herpes) is a common, recurrent viral infection affecting the eyes. The exact cause of an outbreak is unknown, but it is believed that it is caused by type 1 herpes simplex virus. The herpes simplex virus enters the body through the nose or mouth and travels into the nerves, where it may be inactive. In some people, however, the virus can be reactivated and spread down the nerves to the face or to an eye. The reasons for this reactivation and reinfection are not completely understood. Probably the stress-related factors such as fever, sunburn, major dental or surgical procedures and trauma may sometime activate the virus.People who wear contact lenses are especially prone to eye keratitis and their risk of infection increases as they wear their contact lenses for longer periods. Eye keratitis can develop into a corneal ulcer if the infection becomes severe.Other risk factors may include:Fever.
  • Ultraviolet light.
  • Cold wind.
  • Vitamin A deficiency.
  • Allergic reaction to something such as eye drops or makeup.
  • Pollutants.
  • Systemic illness.
  • Menstruation.
  • Emotional stress.
  • Local trauma.
  • Immunosuppression.
  • Trigeminal nerve manipulation.
Types may include:Epithelial keratitis: Involvement of the superficial layer of the cornea is the most common ocular manifestation and is typified by a dendritic ulcer.
  • Stromal keratitis: Involvement of the middle layer of the cornea is less common. Stromal disease occurs when viral antigen passes to the stroma and induces an immunological reaction. Usually this induces a disciform (having a round or oval shape like a disc) edema but a more severe inflammatory response can cause necrotizing stromal keratitis.
About 1-2 people in 1000 will develop at least one episode of eye keratitis at some stage in their life. The most common age for a first episode is aged 35-40.Symptoms:Symptoms may include:Blurred vision.
  • Sensitivity to light.
  • Pain and redness of the eye.
  • Tearing.
  • Decreased vision.
  • Swollen preauricular nodes.
  • Swelling and redness of the eyelid.
  • Reduced visual acuity.
  • Reduced corneal sensation.
Diagnosis:Your physician (ophthalmologist) looks for infection in the front of the eye with a slit lamp. He/she will test the patient's vision and then examine the eyes with a slitlamp. The cornea can be examined with fluorescein, a yellow dye which will highlight defects in the cornea. Deeper layers of the cornea can also be examined with the slit lamp. He/she may scape a sample from the surface of the cornea for laboratory evaluation, to determine what type of bacterium, virus, or fungus is causing the infection.Treatment:Treatment is with antiviral eye ointment or drops (such as acyclovir ointment or ganciclovir drops). These do not kill the virus but stop it from multiplying further until the infection clears. You should take the full course exactly as prescribed. In some cases, a specialist may also gently scrape the affected part of the cornea to remove affected cells.Treatment may vary for deeper, more severe corneal infection and for herpetic inflammation within the eye. The antiviral eyedrops presently available are less effective in treating these severe infections. Steroids, in the form of drops, may help decrease inflammation and corneal scarring.Note: Steroid eye drops must only be used under close supervision of an eye specialist who will prescribe the correct strength and dose in conjunction with antiviral treatment.Despite the available treatments, some patients do not respond well or rapidly to treatment. These patients may have prolonged inflammation and ultimately permanent corneal scarring and may need corneal transplantation to restore their vision.Disclaimer: The above information is educational purpose. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition.DISCLAIMER: This information should not substitute for seeking responsible, professional medical care.


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