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What is Keratitis?

Keratitis (also known as “corneal ulcer”) is an inflammation of the cornea – the clear, dome shaped window located at the front of the eye that covers the iris and pupil. Keratitis resulting from infections (called infectious keratitis) can be caused by bacteria, viruses, fungi, and parasites. Keratitis can also occur a result of other insults to the cornea (called noninfectious keratitis) such as an injury, wearing 225 West Wacker Drive your contact lenses too long, or very dry eye. Keratitis can Suite 400 Chicago, Illinois 60606 become serious quickly – see your eye doctor right away 800.331.2020 PreventBlindness.org to prevent vision loss.

Cornea: the clear, curved front of the eye. Iris: the colored part of the front of the eye. Pupil: the black part in the center of the eye. It is controlled by the iris and it controls the amount of light that enters the eye (like a camera lens). Conjunctiva: the clear mucous membrane that covers the white part of the eyeball and the inside of the eyelid.

What Causes Keratitis? grow on your contact lenses or contact lens case if you do not clean Keratitis can be infectious or and store them properly. The bacteria non-infectious. can also come from contaminated Infectious keratitis eye drops or contact lens solution. Bacterial infections: Bacterial It is more likely to occur if you wear keratitis is common in people who extended-wear contact lenses wear contact lenses. Bacteria can (contact lenses that you sleep in).

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Viral infections: Keratitis from a injury may also let in bacterial viral infection is usually due to the or fungus to cause an infectious herpes simplex virus, the chicken keratitis. pox virus, or the common cold. Eyelid disorders that prevent If you’re sick, be careful about proper eyelid function: If the touching your eyes and keeping eyelid does not close properly, the your hands clean. If you have a cold cornea can dry out, and keratitis sore (the herpes simplex virus), can develop. you can spread it by touching your Dry eye syndrome: The eyes are sore and then your eye. The virus Eddie314 at the English language Wikipedia Eddie314 not able to leave a protective layer that causes cold sores may cause Non-infectious keratitis of tears (called the tear film) that repeated keratitis infections. The

- washes, soothes and protects the repeated infections are triggered by eye every time you blink. The eye stress, an impaired immune system, then becomes dry and irritated or exposure to sunlight. which can lead to keratitis. Fungal infections: This type of Exposure to intense ultraviolet keratitis infection is not common. (UV) light (photokeratitis): It can be caused by scratching Lorenzo-Morales et al 2015 - 10.051/para Lorenzo-Morales et al 2015 site/2015010 Photokeratitis is caused by damage your eye with a branch or plant Parasitic (Acanthamoeba) infection to the cornea by UV light. It can be material. It can also be caused by caused by the reflection of UV light the improper use of contact lenses from the sun from sand, water, ice or steroid eye drops. and snow; looking directly at a solar Parasitic (Acanthamoeba) eclipse without eye protection, infection: Acanthamoeba are tanning beds, and/or welding. microscopic, single-celled organisms called amoeba. They What are the Symptoms are the most common amoebae of Keratitis? found in fresh water and soil. The The first sign and symptoms of Note: Conjunctivitis (also two biggest risk factors to get an keratitis is usually eye pain, known as “pink eye”) is Acanthamoeba infection are poor redness, and blurred vision. Your contact lens hygiene and exposure an inflammation of the eye may burn or feel irritated, to water (like swimming pools or it may feel like you have conjunctiva. This condition and hot tubs) while wearing something in it. contact lenses. has similar sympotoms Signs and symptoms of keratitis and may be confused with Non-infectious keratitis include: Injury: Scratches, scrapes and • Eye pain keratitis. If you have the cuts to your cornea can cause • Eye redness keratitis symptoms listed noninfectious keratitis. These injuries can happen from a variety • Excess tears or other discharge above, see your eye doctor of sources, such as fingernail from your eye right away. scratches, paper cuts, makeup • Difficulty opening your eyelid brushes, tree branches, contact because of pain or irritation lenses, and chemical burns. The • Blurred vision

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• Decreased vision • Have or have had cold sores, • Sensitivity to light (also called chicken pox, or shingles photophobia) • Have dry eye

• A feeling that something is in • Have an eyelid disorder that your eye prevents proper functioning Keratitis can cause permanent of the eyelid vision loss, so see your eye doctor • Not wearing proper eye right away if you have any of these protection (such as sunglasses, symptoms. welding mask, etc.) to avoid What Increases the Risk exposure to UV light for Keratitis? If you wear contact lenses: Safe handling, storage and cleaning of You may be at increased risk for your contact lenses are key steps keratitis if you: to reduce your risk of keratitis. It is • Wear contact lenses: Wearing important to learn how to take care contact lenses (especially of your contact lenses. For more sleeping in the lenses) increases information, visit: your risk of both infectious www.preventblindness.org/ and noninfectious keratitis. The wearing-contact-lenses. risk increases from: How is Keratitis Diagnosed? • Wearing them longer than recommended If you notice any of the signs or • Improper disinfection symptoms of keratitis, make an appointment to see your eye doctor • Wearing contact lenses right away. If you wear contact while exposed to water (like lenses, do not wear them until you swimming pools or hot tubs) find out what is wrong. Bring your • Have reduced immunity: contact lenses and contact lens If your immune system has case with you to the eye exam. been weakened by disease or Delays in diagnosis and treatment medications, you are at a higher of keratitis can lead to serious risk of developing keratitis. complications, including blindness. • Use steroid eye drops: Use of At your eye exam, the eye doctor steroid eye drops to treat an eye will perform the following tests: disorder can increase your risk • History: The eye doctor will take of developing infectious keratitis a medical history, identify any or worsen existing keratitis. illness, and ask you about your • Have an eye injury: If one of symptoms before examining your corneas has been damaged your eye. from an injury, you may be • Visual acuity: This test will more vulnerable to developing show how well you can see. keratitis.

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• Penlight exam: The eye doctor Infectious keratitis may examine your eye using a Treatment of infectious keratitis penlight, to check your pupil’s varies, depending on the cause of reaction, size, and other factors. the infection. • Slit-lamp: The eye doctor uses • Bacterial keratitis: Depending a special microscope called a on the severity of your infection, slit lamp. It shines a light into antibiotic eye drops may be one eye at a time so the doctor used for mild cases. In moderate can look closely at the outside to severe cases, you may also and inside of the eye. Your need to take oral antibiotics treat eye doctor may apply a stain the infection. (fluorescein) to the surface of • Fungal keratitis: You would need your eye, to light up any damage to take antifungal eye drops and to your cornea. oral medication. Laboratory analysis: • The eye • Viral keratitis: You may need doctor may swab under your artificial tear drops, antiviral eyelid to get a sample of tears or eye drops and/or oral antiviral some cells from your cornea for medications. laboratory analysis. The doctor Acanthamoeba keratitis: might also swab your contact • This lens case as a separate sample keratitis may be difficult to treat. for analysis. This will help to You may be prescribed antibiotic determine the cause of keratitis drops. If you have a severe case, and develop a treatment plan for a corneal transplant may be your condition. needed. Your eye doctor may also prescribe How to Treat Keratitis? steroid eye drops (never with fungal Noninfectious keratitis keratitis) after your infection has A very mild case of noninfectious improved or is gone. These drops keratitis will usually heal on its own. help to reduce swelling and help For mild cases, your eye doctor prevent scarring. You should only may recommend that you use use steroid eye drops under close artificial tear drops. If your case is supervision by your eye doctor more severe and includes tearing because steroid eye drops can and pain, you may need to use sometimes make an infection antibiotic eye drops to help with worse. symptoms and prevent infection. Surgical Treatment For information on how to properly take eye drop medications, visit: A corneal transplant replaces a www.preventblindness.org/taking- damaged cornea with a healthy eye-drop-medications. donor cornea. You may require a

Prevent Blindness 4 Keratitis (continued)

corneal transplant if you have the • Keep the area where you store following: and keep your contact lenses • Keratitis that does not respond and contact lens case clean to medication and germ free • Corneal scarring that greatly • Never store contact lenses in impairs your vision tap water • Do not sleep in contact lenses What Causes Vision Loss when you are supposed to take from Keratitis? them out every night Keratitis, if caught early, is usually • Do not swim or shower in your easy to treat and clears up quickly. contact lenses Corneal scarring is the most • Replace your contact lenses and common complication of keratitis, contact lens storage case as which can lead to vision loss. If recommended keratitis is not treated in a timely manner, the infection could go Resources for Eye Care through the cornea and spread to Prevent Blindness has a list of other areas of the eye leading to financial assistance resources possible blindness. It is important for those in need of support in to see any eye doctor as soon as meeting their eye health needs symptoms of keratitis are noticed. and medications. Visit: www. How to Prevent Keratitis? preventblindness.org/visioncare- financial-assistance-information. If you are sick, wash your hands often and try not to touch your eyes. Wear proper eye protection if you are looking at intense UV light. And if you wear contact lenses, handle and care for them correctly: • Follow your eye doctor’s recommendations for taking care of your contact lenses • Wash your hands and make sure they are completely dry before touching your contact lenses or your eyes • Always use fresh solution to clean and store your contact lenses

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