According to abbreviationfinder, corneal inflammation, also known as keratitis, is an inflammatory change in the cornea of the eye. It is associated with pain, decreased tear flow, increased sensitivity to light, and reduced vision. In most cases, the corneal inflammation heals without any consequences – however, if treatment is not given for a long time, a transplant may even be necessary.
What is corneal inflammation?
The normal cornea of the eye is a clear, multi-layered tissue. Their inflammation can be caused by various reasons. The degree of this inflammation of the cornea varies from case to case, extending only to one or to several layers of the cornea.
If it is limited to the surface, it is primarily characterized by a slight turbidity. This cloudiness becomes denser as more layers are affected. Since the condition of the cornea has a significant effect on vision, timely treatment of the disease is imperative.
This is the only way to prevent serious scarring or corneal detachment and to enable the corneal inflammation to heal without complications.
Causes
Typical triggers of corneal inflammation are infections caused by bacteria or viruses, fungal infestation, hereditary predisposition and injuries to the eye. In addition, however, the inflammation can also appear as a side effect of an underlying disease such as diabetes mellitus or an HIV infection.
Caution when dealing with other people is always required if the corneal inflammation was triggered by an infection: Transmission of the respective pathogen is possible. Group A streptococci, pseudomonas, staphylococci or chlamydia are often associated with such an inflammation.
Herpes or adenoviruses are also known to cause an inflammatory change in the cornea. Infestation with fungi, on the other hand, is less common. In addition to the causes already mentioned, corneal inflammation can also be caused by dry eyes, chemical burns or the influence of UV rays.
Symptoms, Ailments & Signs
A number of different symptoms can occur in the course of corneal inflammation. They vary greatly depending on the specific cause of the keratitis and can be of varying intensity. A typical sign of corneal inflammation is severe eye pain. These are usually associated with impaired vision and a more light- sensitive eye.
If the person concerned looks directly into the light, the symptoms increase significantly. A persistent foreign body sensation in the affected eye is also characteristic of keratitis. As a result, those affected often reflexively close their eyes. A spasm of the eyelids ( blepharospasm ) occurs. This is accompanied by a strong dripping of tears and possibly also a watery or purulent flow of secretions.
The eye is usually clearly reddened. While at the beginning of the disease only a cloudiness can be seen in the eye, a particularly striking reddening can be seen in the advanced stage. In some cases, tissue damage or growths on the cornea are also visible. In the case of hereditary corneal inflammation (keratitus bullosa), the cornea of the eye may become blister-shaped. There is a risk of these blisters bursting, which can lead to further pain.
Diagnosis & History
Since corneal inflammation is usually associated with pain, a reduction in vision and significantly reduced tear flow, most people see a doctor within a very short time. This is an important and essential step because of the consequences associated with prolonged non-treatment.
To make a diagnosis, doctors use different examination methods. The initial suspicion arises from the questioning of the patient and the symptoms of the disease. With the help of special lighting from a flashlight, the eye is then subjected to a thorough examination, which reveals changes inside the eyeball.
Blistering, proliferation, corneal detachment and injury as well as opacities can be clearly identified. The examination known as the Schirmer test, with which the flow of tears can be determined, can also contribute to the diagnosis. A swab of the conjunctiva also gives the doctor information about whether it is an infectious corneal inflammation and which pathogen has triggered it
If the disease is recognized and treated in time, it can be expected to heal without consequences. However, if there is no treatment over a longer period of time, the corneal inflammation can have far-reaching consequences and may even require a transplant.
Complications
In most cases, the inflammation of the cornea causes pain in the eye. This pain also occurs in the form of rest pain and can therefore have a very negative effect on the patient’s everyday life. It is not uncommon for this to lead to irritability and to psychological complaints and depression. Pain at rest can also lead to trouble sleeping at night.
Furthermore, the corneal inflammation also has a negative effect on the eyesight of those affected. In the worst case, the patient can become completely blind. The sensitivity of the eye to light also increases. The eyes are dry and the flow of tears is greatly reduced. This can lead to complications if there is a foreign body in the eye and there is not adequate tear flow. The cornea is usually clouded by the inflammation.
As a rule, there are no special complications during treatment. The corneal inflammation is treated with the help of antibiotics and other drugs and leads to success relatively quickly. Eye drops may also be necessary to treat the inflammation. The disease does not affect the life expectancy of the patient. After the treatment, the symptoms usually disappear completely.
When should you go to the doctor?
If symptoms such as sensitivity to light, blurred vision and eye pain occur, there may be an underlying corneal infection. A doctor should be consulted if symptoms persist for more than a few days. If there are other signs of corneal inflammation, it is best to consult an ophthalmologist immediately. Contact lens wearers should remove contact lenses immediately and protect their eyes from further irritation. At the latest when a white or gray opacity is noticed on the surface of the cornea, medical advice is required.
Other warning signs are purulent discharge and an increasing feeling of pressure in the area of the eyes. So that no further complications arise, you must go to the doctor immediately with these symptoms. In the case of acute symptoms, for example if the eyesight is severely restricted after waking up, the person concerned should call the emergency services. People who suffer from an immune deficiency or who have recently contracted a viral infection are particularly at risk. Diabetes, fungal infections and bacterial diseases are also possible triggers. Anyone who belongs to this risk group should see a doctor immediately with the symptoms mentioned. In addition to the family doctor, the ophthalmologist is the right contact person.
Treatment & Therapy
The form in which the corneal inflammation is treated depends largely on the cause of the disease. In the case of infectious inflammation, for example, drugs are administered that are specially tailored to the pathogen found in the individual case.
This guarantees maximum treatment success within a very short time. Typically, antibiotics such as tetracyclines are prescribed for bacteria, while antivirals are used to fight viruses. Fungal infection should continue to be treated with the administration of antifungal drugs.
The treatment is different if the trigger of the corneal inflammation is the dryness of the eyes associated with reduced tear flow. Here it is advisable to rely on special massages of the edge of the eyelid and, if necessary, to alleviate the symptoms with the help of artificial tears.
The following also applies: If the corneal inflammation is only a tolerable side effect of an underlying disease, the therapy of this disease is of the utmost importance.
Outlook & Forecast
It is very difficult to give an exact outlook and prognosis in the case of an existing corneal inflammation, since this clinical picture occurs in different degrees of severity. Another factor that greatly influences the prognosis is the trigger of the inflammation. The earlier appropriate treatment is initiated, the shorter the duration of the disease and the shorter the risk of further complications.
Normally, corneal inflammation can be treated very well and effectively, so that a significant improvement can be expected within a few days. For more severe infections, it can take up to two weeks to heal. Medical or drug treatment is necessary for corneal inflammation, as otherwise permanent consequential damage can occur.
In the worst case, there is a risk of permanent damage to the cornea, with complete blindness in the affected eye. Sight could not be restored even by surgery.
Prevention
The development of corneal inflammation can only be counteracted to a limited extent due to the diversity of its causes. It proves to be helpful to observe certain behaviors – such as regular cleaning of contact lenses and their containers as well as protection of the eyes from direct sunlight. If typical risk factors are present, regular eye examinations are also recommended.
Aftercare
Following the corneal inflammation, close medical care is important. The patient should consult the doctor after a few days so that any complications that may arise can be recognized and treated immediately. In the subsequent period, the ophthalmologist should be consulted regularly, especially in the case of chronic or severe inflammation that is associated with severe symptoms.
In the case of severe corneal inflammation, the eye should initially be checked two to three times a week as there is a high risk of complications. In addition, some rules of conduct must be observed. Do not rub or squeeze the affected eye.
External stimuli in the form of cold drafts, dust or direct sunlight should also be avoided by protecting the eye with a medical eye patch or other aid. Patients who expose their eyes to greater stress at work should first take sick leave.
The prescribed medication should continue to be used as directed until the inflammation has completely resolved. If unexpected symptoms occur, for example a sudden deterioration in vision or severe pain in the area of inflammation, it is advisable to consult a doctor. If you have minor symptoms, you can wait for the next check-up appointment.
You can do that yourself
If the corneal inflammation was caused by an infection with bacteria, viruses or fungi, the patient must pay more attention to hygiene. Many people regularly touch their faces or rub their eyes. However, these mostly harmless gestures can lead to pathogens on the hands getting into the eyes and triggering or increasing an infection there. Those affected should therefore wash their hands regularly and check their gestures . Anyone who uses contact lenses should clarify with their doctor whether they can be worn despite keratitis or whether glasses must be used.
If the cornea becomes inflamed because the eye produces too little natural tear fluid, artificial tears can be used instead. In addition, people who suffer from dry eyes and work at the screen should take regular breaks and blink vigorously, which stimulates tear production. In addition, care should be taken to ensure that the humidity in the workplace and at home is sufficiently high. It often helps to set up large bowls of water and air them regularly. On longer flights, thermal water sprays from the pharmacy, which are also available in handbag format and are usually allowed in the cabin, can provide relief.
