Cornea

Keratitis

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Keratitis, Corneal Injury, Corneal Trauma, Corneal Inflammation

  • Definition
  1. Corneal Inflammation
  • Etiology
  1. Secondary to Scleritis or Episcleritis
  2. Superficial punctate Keratitis (pinpoint Corneal lesions)
    1. Exposure to sun or Sunlamp (UV Keratitis)
    2. Arc-welding
    3. Contact Lens overuse
    4. Corneal Abrasion from foreign body
  3. Infection
    1. Bacterial Keratitis (esp. Contact Lens wear)
      1. Pseudomonas (esp. yellow-green discharge)
      2. Staphylococcus aureus
      3. Serratia
    2. Viral Keratitis
      1. Herpes Simplex Keratitis (dendritic lesion)
      2. Varicella Zoster Virus (Herpes Zoster Ophthalmicus)
      3. Epstein-Barr Virus
      4. Cytomegalovirus
    3. Parasitic Keratitis
      1. Acanthamoeba (esp. poor Contact Lens hygiene or water exposure while wearing)
        1. Severe Eye Pain, redness and photophobia for weeks
        2. Infiltrate in shape of ring over Cornea
  • Symptoms
  1. Moderate to severe Eye Pain
  2. Moderate to severe Foreign body Sensation
  3. Blurred Vision
  4. Watery to mucopurulent Eye Discharge
  5. Photophobia
  6. Eye tearing
  7. Painful Red Eye
  • Signs
  1. Conjunctival injection and Ciliary Flush
  2. Corneal vascularization (sclerosing Keratitis)
  3. Corneal Opacification (sclerosing Keratitis)
  4. Decreased Visual Acuity (depending on location)
  5. Normal or reduced pupil size
  6. Fluorescein Staining for Corneal Epithelial Disruption
    1. Keratitis may have a more diffuse uptake
    2. Corneal Ulcer (Ulcerative Keratitis)
  7. Hypopyon
  • Management
  1. Ophthalmology Consultation
  • References
  1. Pflipsen (2016) Am Fam Physician 93(12): 991-8 [PubMed]