Are your eyes red and itchy? It could be keratoconjunctivitis!

Have you ever noticed that your eyes are red, itchy, and sometimes even stinging? We all have to face these kinds of experiences in our daily lives, right? So, today we are going to talk about a condition that can be so uncomfortable, but can be easily managed if we are properly informed. This is called Keratoconjunctivitis. Don't worry, the name may sound a bit long, but let's keep it simple.

What is this keratoconjunctivitis?

Simply put, keratoconjunctivitis is an inflammation of the outermost layer of your eyeball. Think of it like a camera. It has parts that are visible to the light. In this case, both of those outer parts become inflamed, meaning they become swollen, red, and painful.

Shall we explain a little more?

1. Keratitis: This is an inflammation of the cornea , the transparent membrane that covers the iris (the colored part of your eye and the pupil). It's like the glass in our windows.

2. Conjunctivitis: You may have heard of this as " pink eye . " It is an inflammation of the conjunctiva , the thin membrane that covers the white part of the eye (the sclera).

So, keratoconjunctivitis is a combination of these two conditions . This means that the entire surface of your eye is affected by something that is bothering you. This can be a little more severe than a typical eye infection.

Are there different types of this?

Yes, there are many causes of this keratoconjunctivitis. Some of the causes have even been given different names. These can be called subtypes. Let's look at a few examples.

• Keratoconjunctivitis sicca: This is actually a type of dry eye disease . 'Sicca' means dryness. Your eyes become dry due to a problem with the tear-producing system in your eyes, which causes inflammation. Think of it this way: tears are like oil to a machine. This problem occurs when there is not enough of them.
• Vernal keratoconjunctivitis (VKC): This is caused by an allergic reaction . This allergy occurs especially to things like pollen and dust in the air. For some, this is a temporary condition, but for others it can be a chronic condition. This is more common in areas of our country that have dusty weather.
• Superior limbic keratoconjunctivitis (SLK): This is also a chronic inflammatory disease. It mainly affects the upper edge of the cornea (the ``superior limbus`'). The exact cause of this is not yet known.
• Epidemic keratoconjunctivitis (EKC): This is a highly contagious viral infection . It is caused by a group of viruses called adenoviruses . These viruses usually affect our respiratory system, but they can also affect the eyes. Once it occurs, there is a high chance of spreading it to other people in the home and office.

What are the symptoms of this? How do you feel?

A person with keratoconjunctivitis may experience one or more of the following symptoms:

• Eye discomfort: It may feel like there is a grain of sand in the eye, itchy, or burning.
• Eyelid inflammation (`Blepharitis`): The eyelids become red, swollen, and sometimes the tip of the eyelid may look like a wound.
• Small blisters in the eyes or on the eyelids: Sometimes you can see small bumps that look like boils.
• Red or pink eyes: Red eyes, similar to "stinging eyes".
• Watery eyes: Just like tears coming out.
• Discharge or other fluid from the eyes: Your eyes may be sticky when you wake up in the morning.
• Light sensitivity: Feeling difficult to look at sunlight or bright lights.
• Blurred vision: Not seeing clearly, looking like fog.

Important: If you have any of these symptoms, especially if you have discharge from your eyes or if your vision seems to be changing, it is best to seek medical advice.

Why does eye inflammation occur like this? What are the causes?

As we've said before, inflammation is our body's immune system's response to a threat. This inflammation occurs when our body's defense system thinks, "Oh, something's wrong here."

There are many causes of keratoconjunctivitis, including:

• Infectious diseases:
• This condition can be caused by various germs, including viruses (e.g. herpes - `Herpetic keratoconjunctivitis`), bacteria (e.g. chlamydia - `Chlamydial keratoconjunctivitis`), and some types of fungi (`Microsporidial keratoconjunctivitis`).
• Allergic and hypersensitivity reactions:
• This can occur if you are allergic to things like pollen, dust, and animal dander (`Phlyctenular keratoconjunctivitis`, `Atopic keratoconjunctivitis`, `Vernal keratoconjunctivitis`).
• Exposure and dryness (`Exposure`):
• When the eyes do not produce enough tears (the condition we mentioned earlier, `Keratoconjunctivitis sicca`), or when the eyes are unable to close properly, the surface of the eye can be damaged by exposure to environmental factors.
• Nerve damage:
• If our fifth cranial nerve is damaged, a condition called ``Neurotrophic keratoconjunctivitis`` can occur. This is when the cornea loses sensation and stops protecting and repairing itself.
• Autoimmune and autoinflammatory diseases:
• Sometimes, autoimmune diseases, which are caused by a malfunction in our immune system, can cause persistent inflammation in various parts of the body, including the eyes.
• Toxic products:
• This condition can occur when certain chemicals, medications, or environmental toxins get into the eye, damaging the surface of the eye. Some people can also have a reaction to the preservatives in eye drops.

How does a doctor detect this?

When you see an eye care provider, they will first ask you about your symptoms and medical history. They may also ask about any other medical conditions you have or any recent illnesses you have had. In addition, they may do some tests, such as:

• Eye examination with a special instrument: Your eye will be examined with a device called a `slit lamp`, which will magnify your eye. You may also be given a `fluorescein eye stain test`. This involves applying a special dye to your eye and checking for any scratches or wounds on the cornea.
• Examining the fluid coming from the eyes: This test helps to determine exactly if there is an infection and what germ is causing it.
• Lacrimal function tests: These tests are done to see if your eyes are producing tears properly.
• Eye Imaging Tests: Sometimes, tests such as an ultrasound or MRI may be performed to look at the inside of the eye.

What are the treatments for this?

Keratoconjunctivitis is treated depending on the cause. Here are some common treatments:

• Artificial tears: If your eyes are dry, you can use these to keep them moist. There are also special lubricating ointments to use at night while you sleep.
• Warm or cold compresses or lid scrubs: These can help cleanse the eyes and reduce discomfort.
• Specialized eye drops: For an infection, eye drops containing antibiotics can be given, and for an allergy, eye drops containing antihistamines can be given.

In very severe cases, some people may need to have eye surgery , but this is rare.

When should we see a doctor?

If your eyes are red, itchy, or uncomfortable, you should definitely see a doctor. Especially if you have unusual discharge from your eyes or a change in your vision, seek medical advice immediately. Some causes of keratoconjunctivitis can be more serious than others.

You can also ask the doctor questions like these:

• What type of keratoconjunctivitis do I have?
• Is this a short-term or long-term thing?
• What kind of treatment do I need?
• Will my eyes heal completely?

How can we protect ourselves from this?

Taking good care of our eyes can reduce the risk of developing keratoconjunctivitis. For example:

• Wash your hands often. Avoid touching or rubbing your eyes as much as possible. Germs on our hands can enter our eyes without us realizing it.
• If you wear contact lenses, use them safely. Always use clean lenses, never sleep in them, and clean them as your doctor tells you.
• If you have dry eyes, ask a doctor about appropriate treatments.
• When going outdoors, wear sunglasses or other suitable eye protection. This will protect your eyes from things like dust and wind.
• Avoid things you know you are allergic to as much as possible. If necessary, use allergy medication.

What happens if this happens? Will it heal?

The outcome (prognosis) depends on the type of keratoconjunctivitis you have. Some types resolve quickly with proper treatment. Others are chronic conditions, meaning they can recur throughout your life. In such cases, you may need ongoing treatment to control your symptoms.

The best part is that treatments for keratoconjunctivitis are usually successful . They can reduce inflammation and often address the underlying cause of the condition. However, if it becomes severe enough, it can cause permanent damage to the eyes. Therefore, it is important to seek treatment as soon as possible.

If your eyes are itchy, sore, or have redness where the whites should be, be sure to see an eye care specialist for an eye exam. Inflammation is something that can damage your sensitive eye tissue, and it doesn't matter if it happens to you regularly. It's important for your doctor to determine exactly whether it's a seasonal allergy, an infection, or something more rare, and to determine the best treatment for you.

So, what are the things we need to remember? (Take-Home Message)

Okay, there are a few things to keep in mind from what we've talked about:

• If you experience eye discomfort, redness, itching, or discharge, don't just ignore it. Even if it seems like a minor issue, there could be something else going on.
• Seek medical advice immediately, especially if your vision becomes blurry, you have difficulty seeing light, or you have a lot of squinting.
• Keratoconjunctivitis is a treatable condition, but the exact cause needs to be identified and treated appropriately.
• Eyes are a very valuable asset. Therefore, always take care of your eye health. Follow the protective measures we discussed earlier.

I hope you found this information useful. Healthy eyes are the key to a healthy life!

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