pl. keratitides [kerato- + -itis]
Inflammation of the cornea, usually associated with decreased visual acuity and, if untreated, sometimes resulting in blindness. Pain in the eye, tearing, sensitivity to light, and impaired vision are the most common symptoms.
It is often caused by contact lenses, but it may also result from drugs, microorganisms, immunodeficiency, trauma, or vitamin A deficiency.
Therapy depends upon the cause. Bacterial infections respond to antibacterial medications (typically administered in drops); herpes simplex viral infection requires antiviral agents; fungal keratitis is treated with antifungal agents; exposure keratitis, as in Bell palsy, is preventable with topical lubricants.
Because of the seriousness of keratitis, patients experiencing eye inflammation or pain should seek immediate medical attention. The patient is assessed for a history of recent upper respiratory infection accompanied by cold sores, pain, central vision loss, the sensation of a foreign body in the eye, use of contact lens, photophobia, and blurred vision. The eye is inspected for inflammation and loss of normal corneal luster. A slit lamp examination is often used for optimal viewing of the eye to confirm the condition. Fluorescein staining helps determine the extent and depth of corneal ulceration. The patient should refrain from rubbing the eye because of the complications rubbing may cause. Prescribed therapies are administered, and the patient is instructed in their use. Warm compresses are applied as prescribed to relieve pain. If the patient complains of photophobia, the use of dim lighting or wearing sunglasses is recommended. The patient should follow the prescribed treatment regimen carefully for the entire course and return for follow-up examination.
Patient education: the correct instillation of prescribed eye medications and the importance of thorough handwashing before and after touching the eye are emphasized. Contact lenses are removed and are not replaced until infectious forms of keratitis are cured. Any potentially contaminated lenses or lens solutions should be discarded. Stress, traumatic injury, fever, colds, and overexposure to the sun may trigger flare-ups. Both patient and family are taught about safety precautions pertaining to visual sensory or perceptual alterations. They are encouraged to discuss their fears and concerns. Appropriate information and emotional support and reassurance are provided.
Because many common forms of keratitis are infectious, examiners should use standard precautions during the evaluation of the eye.
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