Are your eyes sore, red, and sensitive to light? It could be keratitis!

Do your eyes often feel sore, red, or watery? Do you sometimes feel like something is stuck inside your eye? You should never ignore these signs and brush them off as a simple irritation.

These warning signs might point to a painful eye condition called keratitis. Let us take a closer look at what keratitis is and why you need to know about it.

What Is Keratitis?

Put simply, keratitis is inflammation of your cornea. Your cornea is the clear, dome-shaped window at the very front of your eye that covers your colorful iris and dark pupil.

When this delicate tissue becomes inflamed, it can lead to a painful corneal ulcer or sore. Doctors generally split keratitis into two main groups.

The first group is infectious keratitis, often called microbial keratitis. The second group is noninfectious keratitis.

Early signs include eye pain and redness. If you notice these symptoms, you should visit a doctor right away.

Left untreated, keratitis can cause serious damage and even lead to blindness. In many parts of the world, especially in developing nations, keratitis is a leading cause of corneal blindness.

How Common Is Keratitis?

Keratitis is a very common and treatable medical condition. However, outside of developed regions like the United States, infectious keratitis remains a major cause of vision loss.

Some types of infectious keratitis can spread from person to person through contaminated items, coughing, or sneezing.

What Are the Symptoms of Keratitis?

Let us look at the common signs and symptoms of keratitis so you know what to watch out for:

• Severe eye pain or discomfort.
• Watery eyes with constant tearing.
• Red eyes with a burning feeling and bloodshot appearance.
• Sensitivity to bright light, known as photophobia.
• Blurry or hazy vision.
• Difficulty opening your eyelids due to pain or irritation.
• A persistent feeling that something is stuck inside your eye.

What Causes Keratitis?

Keratitis can develop due to infections or noninfectious triggers. Let us explore both categories.

How Infectious Keratitis Happens.

Infectious keratitis occurs when harmful germs invade your cornea. The primary infectious causes include:

• Bacterial infections: This is the most common type of keratitis. It often happens when bacteria enter the eye through dirty hands or poorly cleaned contact lenses.
• Fungal infections: Fungi from plants, soil, or organic matter can enter your eye. This can happen if a tree branch scratches your eye while you garden.
• Parasitic infections: Acanthamoeba keratitis is a rare and serious infection caused by a tiny single-celled parasite. It often spreads through contaminated swimming pool water, rivers, or poorly maintained contact lenses.
• Viral infections: Viruses like the herpes simplex virus or the virus that causes shingles can trigger keratitis. Herpes simplex keratitis tends to flare up repeatedly over time.

How Noninfectious Keratitis Happens.

You can also develop keratitis without an active infection. Common noninfectious causes include:

• Eye injuries: Scratches, minor surgical trauma, or eyelashes rubbing against your cornea can trigger inflammation.
• Overwearing contact lenses: Keeping your contact lenses in for longer than recommended starves your cornea of oxygen and causes damage.
• Foreign objects: Dust particles, sand, or small insects trapped in your eye can cause irritation.
• UV light exposure: Spending too much time in bright sunlight without UV-blocking sunglasses can harm your cornea. Welders are also at risk.
• Vitamin A deficiency: Lacking essential vitamins like Vitamin A weakens eye health.
• Dry eyes: Severe dry eye syndrome caused by immune issues or eyelid problems can inflame your cornea.

What Are the Risk Factors for Keratitis?

While anyone can develop keratitis, wearing contact lenses is the single biggest risk factor. Key contact lens risks include:

• Wearing lenses for longer than your eye doctor recommends.
• Failing to clean and disinfect your lenses properly.
• Swimming, bathing, or using hot tubs while wearing contact lenses.

Other general risk factors include:

• Using corticosteroid eye drops for a long time.
• Having a weak immune system.
• Suffering from chronic dry eyes.
• having past eye injuries or surgeries.

How Is Keratitis Diagnosed?

Your eye doctor will start by asking about your symptoms and medical history. They may perform several tests to confirm a diagnosis:

• Complete eye exam: The doctor uses a bright light and a specialized microscope called a slit lamp to examine your cornea closely.
• Corneal scraping and culture: The doctor gently takes a tiny sample from your eye to send to a lab and identify the exact germ causing the infection.
• Fluorescein stain test: The doctor places a harmless orange dye into your eye and views it under a blue light to reveal scratches and ulcers on your cornea.

How Is Keratitis Treated?

If you have a mild case of noninfectious keratitis, your doctor may suggest using simple lubricating eye drops and letting your eye heal naturally.

However, infectious keratitis requires targeted medical treatment right away:

• Bacterial infections require prescription antibiotic eye drops.
• Fungal infections require strong antifungal eye drops or oral medicine.
• Viral infections require specific antiviral eye drops or pills.

Once the active infection starts clearing up, your doctor may prescribe steroid eye drops to reduce swelling. They may also give you dilating drops to ease your pain.

Severe cases may require oral medicine. If keratitis leaves deep scars on your cornea that do not respond to medicine, you might need a corneal transplant.

How Quickly Will You Feel Better After Treatment?

If you use anti-infective medicines as prescribed, you should start feeling some relief within a day or two. However, severe infections take much longer to heal completely.

How Can You Lower Your Risk of Keratitis?

You can protect your eyes and lower your risk of keratitis by following these practical tips:

• Follow your eye doctor instructions for wearing and cleaning your contact lenses.
• Wash your hands thoroughly with soap and water before touching your eyes.
• Always use fresh disinfecting solution for your contact lenses.
• Remove your contact lenses before swimming, bathing, or using hot tubs.
• Avoid sharing towels, pillows, or eye makeup with other people.
• Wear protective safety eyewear during sports, home repairs, or yard work.
• Wear UV-blocking sunglasses when you spend time outside in bright sunlight.

What Can You Expect If You Have Keratitis?

Most types of keratitis can be cured successfully with prompt medical care. However, viral keratitis can return again in the future.

Infectious keratitis can sometimes lead to complications such as glaucoma. People with fungal keratitis often experience a slower recovery compared to those with bacterial keratitis.

Warning: If you leave keratitis untreated, it can cause permanent corneal scarring and vision loss. Early medical treatment is essential to protect your sight.

When Should You See a Doctor?

You should schedule an appointment with an eye doctor as soon as you notice eye pain, persistent redness, excessive tearing, or blurry vision.

If your symptoms do not improve after starting treatment, contact your doctor right away for a follow-up review.

Questions to Ask Your Doctor About Keratitis.

Here are some helpful questions you can ask your eye doctor during your visit:

• What specific type of keratitis do I have?
• When can I safely return to work or school?
• Is it safe for me to drive right now?
• How can I manage stress to help prevent recurrent herpes simplex keratitis flare-ups?
• What warning signs should I watch for, and when should I schedule my next follow-up exam?

What Is the Difference Between Keratitis and Uveitis?

The main difference between keratitis and uveitis is the location of the inflammation. While both conditions share similar symptoms, uveitis affects the middle layer of your eye called the uvea.

The uvea includes your iris, choroid, and ciliary body. In contrast, keratitis affects your cornea, which is the clear protective outer layer sitting directly over your iris.

Another common condition with similar symptoms is pink eye, or conjunctivitis. Pink eye affects the thin membrane lining your eyelids, known as the conjunctiva.

When inflammation affects both your cornea and your conjunctiva at the same time, doctors call it keratoconjunctivitis. Mild forms of this condition often affect young children.

Sources & References:

• Mayo Clinic. Keratitis - Diagnosis and Treatment Overview. Available from: Mayo Clinic Patient Care.
• National Health Service (NHS UK). Keratitis and Corneal Ulcers. Available from: NHS Health A-Z.
• Centers for Disease Control and Prevention (CDC). Contact Lens-Related Keratitis. Available from: CDC Healthy Eyes.
• Cleveland Clinic. Corneal Inflammation and Keratitis Guide. Available from: Cleveland Clinic Health Library.
• National Institutes of Health (NIH / PubMed Central). Microbial Keratitis: Clinical Diagnosis and Management. DOI: 10.1038/s41572-021-00287-w.

📖 Scientific Sources & References

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