Keratitis

Diagnosis

Diagnosing keratitis typically involves the following:

• Eye exam. Although it may be uncomfortable to open your eyes for the exam, it's important to have your eye care provider examine your eyes.
• Penlight exam. Your eye doctor may examine your eye using a penlight, to check your pupil's reaction, size and other factors. A stain may be applied to the surface of your eye. Used with the light, this stain makes it easier to see damage to the surface of the cornea.
• Slit-lamp exam. Your eye care provider will examine your eyes with a special instrument called a slit lamp. It provides a bright source of light and magnification to detect the character and extent of keratitis, as well as the effect it may have on other structures of the eye.
• Laboratory analysis. Your eye care provider may take a sample of tears or some cells from your cornea for laboratory analysis to determine the cause of keratitis and to help develop a treatment plan for you.

Treatment

Noninfectious keratitis

Treatment of noninfectious keratitis varies depending on the severity. For example, with mild discomfort from a corneal scratch, artificial tear drops may be the only treatment. However, if keratitis is causing significant tearing and pain, topical eye medications may be necessary.

Infectious keratitis

Treatment of infectious keratitis varies, depending on the cause of the infection.

• Bacterial keratitis. Antibiotic eye drops are the primary treatment for bacterial keratitis. Depending on the severity of the infection, drop frequency can range from around four times a day to every 30 minutes, even during the night. Sometimes oral antibiotics are used as a supplement.
• Fungal keratitis. Keratitis caused by fungi typically requires antifungal eye drops and oral antifungal medication.
• Viral keratitis. If a virus is causing the infection, antiviral eye drops and oral antiviral medications may be effective. Other viruses need only supportive care such as artificial tear drops.
• Acanthamoeba keratitis. Keratitis caused by the parasite acanthamoeba can be difficult to treat. Antiparasitic eye drops are used, but some acanthamoeba infections are resistant to medication and can require treatment for several months. Severe cases of acanthamoeba keratitis may require a cornea transplant.

If keratitis doesn't respond to medication, or if it causes permanent damage to the cornea that significantly impairs your vision, your eye care provider may recommend a cornea transplant.

Preparing for your appointment

You may start by seeing or calling your health care provider if you have eye-related symptoms that worry you. Depending on the type and severity of your symptoms, your provider may refer you to an eye specialist, called an ophthalmologist.

What you can do

• Be aware of any pre-appointment restrictions when you make the appointment. Ask if there's anything you need to do in advance, such as stop wearing contact lenses or stop using eye drops.
• Write down any symptoms you're experiencing, including any that may seem unrelated to the reason for which you scheduled the appointment.
• Make a list of all medications, including vitamins and supplements that you're taking.
• Write down questions to ask during your appointment.

Your time is limited, so preparing a list of questions can help you make the most of your appointment. For keratitis, some basic questions to ask include:

• What is likely causing my symptoms?
• What are other possible causes for my symptoms?
• What kinds of tests do I need?
• What is the best course of action?
• What are the alternatives to the approach you're suggesting?
• I have other health conditions. How can I best manage them together?
• Are there any restrictions that I need to follow?
• Should I see a specialist? Is there a generic alternative to the medicine you're prescribing?
• Are there any brochures or other printed material that I can take with me? What websites do you recommend?
• What will determine whether I need to be seen for a follow-up visit?

In addition to the questions you've prepared, don't hesitate to ask other questions anytime you don't understand something.

What to expect from your doctor

Your provider is likely to ask you a number of questions, including:

• When did you begin experiencing symptoms?
• Have your symptoms been continuous or occasional?
• How severe are your symptoms?
• What, if anything, seems to improve your symptoms?
• What, if anything, appears to worsen your symptoms?
• Has your eye been injured recently?
• Have you been swimming or been in a hot tub recently?
• Do your symptoms affect one eye or both eyes?
• Do you use contact lenses?
• Do you sleep in your contact lenses?
• How do you clean your contact lenses?
• How often do you replace your contact lens storage case?
• Have you had a similar problem in the past?
• Are you using eye drops now or have you used any recently?
• How is your general health?
• Have you ever had a sexually transmitted infection?
• Are you taking prescription medications or supplements?
• Have you recently changed the type of cosmetics that you are using?