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Keratitis - Causes, Symptoms And Treatment- Herpes Simplex Keratitis

What is keratitis?

Inflammation of the cornea (keratitis) may be acute or chronic, superficial or deep. Superficial keratitis is fairly common and may develop at any age. The prognosis is good with treatment. Untreated, recurrent keratitis may lead to blindness.

Causes of keratitis

Keratitis may result from exposure (such as in Bell's palsy where the eyelids don't close). It may also result from infection by herpes simplex virus, type 1 (known as dendritic keratitis because of a characteristic branched lesion of the cornea resembling the veins of a leaf). Less commonly, it stems from bacterial and fungal infections and, rarely, from congenital syphilis.

Signs and symptoms of keratitis

Unilateral keratitis may produce mild irritation, tearing, and photophobia. If the infection is in the center of the cornea, it may produce blurred vision. Left untreated, corneal opacities can occur. When keratitis results from exposure, it usually affects the lower portion of the cornea.

Herpes simplex keratitis

A major cause of adult eye disease, herpes simplex keratitis may lead to:

• Chronic inflammation of the cornea
• Development of tiny blood vessels in the eye
• Scarring
• Loss of vision
• Glaucoma.

Diagnosis

A slit-lamp examination reveals the depth of the keratitis. If keratitis is due to herpes simplex virus, staining the eye with a fluorescein strip produces one or more small branch like (dendritic) lesions; touching the cornea with cotton reveals reduced corneal sensation. Vision testing may show slightly decreased acuity. The patient history may reveal a recent infection of the upper respiratory tract accompanied by cold sores.

Home remedies for the treatment of keratitis

• A sterile, cotton-tipped applicator may be used to gently remove infected tissue and allow the eye to heal more rapidly.
• A patient with keratitis may wear a patch to protect the healing eye from bright light, foreign objects, the lid rubbing against the cornea, and other irritants.
• Minor keratitis (corneal) infections are commonly treated with anti-bacterial or anti-fungal eye drops.
• For cases caused by dry eye, artificial tears for lubrication are usually effective.
• Vitamin supplementation is given in cases where a vitamin A deficiency is the suspected cause.

If the problem is more severe, a person may receive more intensive antibiotic treatment as under to eliminate the infection :-

In acute keratitis due to herpes simplex virus, treatment consists of trifluridine eye drops or vidarabine ointment. A broad-spectrum antibiotic may prevent secondary bacterial infection.

Chronic dendritic keratitis may respond more quickly to vidarabine. Long-term topical therapy may be necessary. (Corticosteroid therapy is contraindicated in dendritic keratitis or any other viral or fungal disease of the cornea.) Treatment for fungal keratitis consists of natamycin.

Keratitis due to exposure requires application of moisturizing ointment to the exposed cornea and of a plastic bubble eye shield or eye patch. Treatment for severe corneal scarring may include keratoplasty (cornea transplantation).

Prevention and special considerations tips

• Many cases of keratitis could be avoided with common sense and good hygiene. Protecting your cornea from cuts with sports and protective eyewear is the first step, since keratitis also results from a corneal injury. If you have a cold sore or genital herpes, avoid touching your eyes - and avoid over-the-counter steroid eye drops, which can worsen this type of infection.
• Children and adults who wear contact lenses should always use sterile lens-cleaning and disinfecting solutions.
• Do not over wear contact lenses at night and remove them if the eyes become red or irritated.
• Also consume a well-balanced diet, including vitamin A-rich foods such as carrots, squash, mangoes, sweet potatoes and spinach.

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