This site is intended for healthcare professionals

Go to /sign-in page

You can view 5 more pages before signing in

Inflammation of the cornea

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

Keratitis is inflammation of the cornea. This may result from a variety of bacterial, viral or fungal infections, or may be non-infective, for example due to trauma or associated with an auto-immune disease.

Inflammation of the cornea commonly presents as

  • a painful red eye with reduced visual acuity due to cellular infiltration and later, corneal oedema
  • blood vessel dilatation is typically concentrated around the limbus - circumcorneal injection
  • often, the conjunctiva is also inflamed - keratoconjunctivitis
  • discharge is usually present and may be watery, mucoid or purulent; notably, it is absent in keratoconjunctivitis sicca
  • pupil may be small due to reflexive miosis; photophobia is common
  • fluorescein readily demonstrates any ulceration (an epithelial breach)

Keratitis an cause significant loss of vision from (1):

  • scarring
  • astigmatism

Complications leading to blindness (2)

  • corneal perforation,
  • choroidal detachment
  • endophthalmitis,
  • phthisis

Corneal ulceration is an ophthalmologic emergency.

  • the cause must be identified before treatment starts since some therapies are beneficial in one circumstance but are aggravating in another
  • refer the same day for urgent ophthalmological review as delay in treatment may result in loss of sight.

Notes:

  • corneal ulceration may occur without keratitis e.g. when a corneal ulcer is secondary to trauma
  • non-infective keratitis may occur in autoimmune diseases
  • risk factors include for development of keratitis include:
    • tear insufficiency,
    • malnutrition,
    • Vitamin A deficiency
      • Vitamin A in combination with zinc maintains conjunctival and corneal surfaces (3)
    • contact lens use
  • microbial keratitis is an ophthalmological emergency which may lead to loss of vision (4)
    • a Japanese study revealed that (5):
      • causative agents of microbial keratitis were
        • gram-positive bacteria (commonest)
        • gram-negative bacteria
        • fungi; and
        • acanthamoeba
      • contact lens wear was the most common risk factor for development of microbial keratitis in this study

Reference:

  1. Tuli SS, et al. Ocul Surf. 2007 Jan;5(1):23-39. Science and strategy for preventing and managing corneal ulceration.
  2. Whitcher JP et al. Corneal blindness: a global perspective. Bulletin of the World Health Organization, 2001; 79 (3).
  3. Heinz C, et al.Corneal perforation associated with vitamin-A-deficiency. Ophthalmologe. 2004; 101(6):614-7.
  4. Curr Opin Infect Dis. 2007 Apr;20(2):129-41
  5. Toshida H et al. Trends in microbial keratitis in Japan.Eye Contact Lens. 2007 Mar;33(2):70-3

Related pages

Create an account to add page annotations

Add information to this page that would be handy to have on hand during a consultation, such as a web address or phone number. This information will always be displayed when you visit this page