Keratitis

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Is the inflammation of the cornea.

Causes

  • Infection: bacterial, viral, or fungal
  • Trauma: chemical, foreign bodies

Signs and symptoms

  • Redness and tearing, blurring of vision, photophobia, acute unilateral painful eye.
  • Dendritic corneal ulcer seen on staining with fluorescein.

Full ocular examination and fluorescein stain are required to confirm diagnosis

Investigations

  • Pus swab for microscopy, culture and sensitivity
  • Corneal scraping for microscopy, culture and sensitivity

Pharmacological treatment

Bacterial

Gentamicin eye drops instil drops every 1-2 hours until infection is controlled 

OR

Ciprofloxacin 0.3%, ophthalmic drops, instil 1 drop every hour for 3 days, then reduce to 1 drop every 3-4 hours.

 

Viral

Acyclovir 3% ophthalmic ointment

Apply every 4 hours. Continue for 3 days after ulcer has been healed

PLUS

Acyclovir, oral

400mg h for 7-10 days depending on the initial response as well as the extent of the ulcer 

Note: Topical corticosteroids are contraindicated

Fungal

5% Natamycin ophthalmic suspension 

Instil one drop every 1-2 hours for 3-4 days, continue for 14-21 days until infection is eradicated.

 

Treatment of non-infectious keratitis

Artificial tear drops. However, if keratitis is causing significant tearing and pain, a 24-hour eye patch and topical eye medications may be necessary.

Refer to an ophthalmologist for specialist