Keratitis Treatment - Fungal 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.

There are several types, including superficial punctate keratitis , in which the cells on the surface of the cornea die; interstitial keratitis , a condition present at birth; herpes simplex viral keratitis , caused by the sexually transmitted herpes virus; and traumatic keratitis , which results when a corneal injury leaves scar tissue.

Causes

Kemtitis 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

The following are the most common symptoms of keratitis. However, each child may experience symptoms differently. Symptoms may include:

• pain and redness in the eye
• discomfort when the child looks at a light (photophobia)
• tearing, watery eyes, or discharge
• blurry vision
• feeling as if something is in the eye

The symptoms of keratitis may resemble other conditions or medical problems. Always consult your child's physician for a diagnosis.

Diagnosis

A case history will be taken and the vision will be tested. Examination with a slit lamp, an instrument that's a microscope and focuses a beam of light on the eye is important for diagnosis. The cornea can be examined with fluorescein, a yellow dye which will highlight defects in the cornea. Deeper layers of the cornea can also be examined with the slit lamp. Infiltrates, hazy looking areas in the cornea, can be seen by the doctor and will aid in the diagnosis. Samples of infectious matter removed from the eye will be sent for laboratory analysis.

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.

Chronic dendritic keratitis may respond more quickly to vidarabine. Long-term topical therapy may be necessary. (Corticosteroid therapy is contraindicated in dendritic kemtitis 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

Prompt, early attention by an ophthalmologist for an eye infection may prevent the condition from worsening to the point of ulceration. Wash hands and pay rigorous attention to cleanliness while handling contact lenses, and avoid wearing contact lenses overnight.

Eating a well-balanced diet and wearing protective glasses when working or playing in potentially dangerous situations can reduce anyone's risk of developing keratitis. Protective goggles can even be worn mowing the lawn so that if twigs are tossed up they can't hurt the eye. Goggles or sunglasses with UV coatings can help protect against damage from UV light.