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
Keratitis usually results 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). It may also result from exposure, due a person's inability to close his eyelids, or from congenital syphilis (interstitial keratitis). Less commonly, it stems from bacterial and fungal infections.
SIGNS & SYMPTOMS
Usually unilateral keratitis produces opacities of the cornea, mild irritation, tearing and photophobia. If the infection is in the center of the cornea, it may produce blurred vision. When keratitis results from exposure, it usually affects the lower portion of the cornea.
TREATMENT
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.
With chronic dendritic keratitis long-term topical therapy may be necessary. Treatment of 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 )corneal transplantation).