Other Corneal Diseases/Infections



her Corneal Infections

Keratitis

Keratitis is an inflammation of the cornea, which is the transparent membrane covering the pigmented part of your eye (iris). Keratitis can occur in both children and adults, and there are various types and causes. Some of the more common risk factors for keratitis are poor contact lens care, illnesses that may increase your body’s susceptibility to infection, herpes or other viral infections, poor hygiene or unhygienic living conditions, and nutritional deficiencies, particularly Vitamin A deficiency.

Herpes Simplex Keratititis

Herpes Simplex Keratitis is a recurrent viral infection. Infections can be brought on by stress, fatigue or ultraviolet light exposure. It often begins with swelling of the membrane lining the eyelid (conjunctiva), and later infections may consist of lesions resembling the veins of a leaf (dendritic keratitis). Sensitivity to light, blurred vision, pain and redness are also symptoms of Herpes simplex keratitis.

Bacterial Keratitis

Redness, pain, blurred vision, and discharge causing eyelids to stick together are common symptoms of bacterial keratitis. It is often caused by improper use of contact lenses. The cornea often appears cloudy with this type of keratitis.

Fungal Keratitis

This type of keratitis usually affects people with weakened immune systems and often results in infection within the eyeball. In recent years, an outbreak of Fusarium keratitis was related to certain contact lens solutions, which have since been recalled. (See “contact lens keratitis” for more information).

Peripheral Ulcerative Keratitis

This type of keratitis infection is generally related to rheumatoid arthritis, polychondritis (connective tissue inflammation) and a rare disease called Wegener’s granulomatosis.

Superficial Punctate Keratitis

Superficial Punctate Keratitis is often linked to viruses that cause respiratory infections (adenoviruses).It often appears as “pinpoint” lesions in the outer layer of the cornea.

Acanthamoeba Keratitis

Often a painful and pus-producing infection, Acanthamoeba keratitis comes from Acanthamoeba, which are naturally occurring amoeba commonly found in water. These parasites may be present in tap water, well water, hot tubs, and sewage systems, and is much more likely to affect contact lens wearers. (See “contact lens keratitis” for more information).

Photokeratitis

Also known as snowblindness, this form of keratitis is caused by excess exposure to UV light. It may occur several hours after light exposure and may last up to 2 days.

Interstitial Keratitis

Considered rare in the United States, this type of keratitis is often a complication of syphilis, and also occurs in people with tuberculosis, leprosy, and other diseases.

Treatment of Keratitis

Antibiotics, antifungals, and antiviral medication are often used to treat the particular source of a keratitis infection. Your doctor will most likely prescribe broad-spectrum antibiotics immediately, but once lab tests determine the source of your infection, the medication may be changed. In some cases, more than one medication may be needed.

Topical corticosteroids should be avoided in diagnoses of herpes simplex keratitis, as these medications may be very harmful in these cases.

Contact Lens Infection

Although they are usually safe, contact lenses may increase the risk of developing various types of infections. Some of the risk factors that may increase the likelihood of contact lens infections are environmental factors, use of extended-wear lenses, poor hygiene, and reduced exchange of tears under the lenses. Following the lens care regimen recommended by your doctor is the best way to prevent contact lens-related infections. It is especially useful to use a “rub and rinse” lens step in your cleaning process, and to avoid contact with chlorinated water while wearing contact lenses. It is also helpful to replace your lens case regularly.

Common Contact Lens Infections Contact lens Keratitis

Keratitis is among the most common contact lens infections. In fact, one in every 2,500 daily contact lens wearers and 1 in 500 overnight contact lens wearers will develop bacterial keratitis each year. Some of the more common pathogens causing this kind of keratitis are Pseudonomas aeruginosa, Staphylococcus aureus and Staphylococcus epidermidis.In recent years, Acanthamoeba keratitis has been on the rise among contact lens wearers. This infection is particularly common in rigid and soft contact lens wearers. Acanthamoeba is common in nature, and is believed to gain access to contact lenses and solutions most likely through tap water. Because it is difficult to treat, it is important to take measures to prevent this infection through proper lens hygiene and usage. In 2007, the Centers for Disease Control (CDC) issued health warnings regarding this particular infection and one type of contact lens solution. This solution has been recalled as a result.

Symptoms

Symptoms of contact lens bacterial keratitis may include intense pain, photophobia (a sensitivity to light), tearing, discharge, and reduced vision. Symptoms are usually rapid in their onset, occurring within 24 hours of infection. In cases of Acanthamoeba keratitis, symptoms occur more gradually, often taking several days or weeks to manifest themselves. Typical complaints include foreign body sensation, mild blurred vision, and redness. It is important you seek medical attention if the symptoms persist for any length of time.

Treatment

In cases of bacterial keratitis, ciprofloxacin and ofloxacin in combination with fortified antibiotics are the first line of treatment. With Acanthamoeba keratitis, topical antimicrobials are prescribed every hour at first and only reduced with decreased toxicity and symptoms. If the outbreak is not identified in the early stages (or if you have waited too long before seeking medical advice), there is a chance the disease will have progressed to the ring infiltrate stage, where surgery will be necessary.

Preventive measures are advocated by your doctor and health care practitioners. Most importantly, never use tap water to rinse or store contact lenses, and do not create a homemade saline solution to use.

Giant Papillary Conjunctivitis (GPC)

This is an allergic form of conjunctivitis that is particularly common to soft contact lens wearers. It often involves both eyes.

Symptoms

Symptoms of GPC include discomfort while wearing contact lenses, redness, itching, blurred vision, bumpy eye surface, and increased shifting of contact lenses with each blink.

Treatment

Your doctor will most likely require you to stop wearing your contact lenses for a period of time, depending on the severity of the GPC infection. The doctor may also suggest a change in the type of lenses you wear (such as daily disposable lenses) or additional lens care regimens. It is important to follow these instructions to prevent future infections. Your doctor may also prescribe a mast cell stabilizer, corticosteroid drops or a histamine blocker to resolve the inflammation.

Demodex Blepharitis

Demodex is a type of mite that lives in facial hair follicles, eyelash follicles and sebaceous glands. There are two types of Demodex mite: Demodex folliculorum, which are longer mites that live in the hair follicles, and Demodex brevis, which are shorter and live in sebaceous glands. These mites tend to be present to some degree in most people, but generally become common starting in middle age, when the immune system begins to weaken. The population of mites usually continues to increase as a person gets older. The Demodex mite may also be responsible for some cases of rosacea. The Demodex folliculorum mite can also live in the eyelash roots and cause a type of blepharitis (eyelid inflammation).

Symptoms

Dandruff in eyelashes, burning, stinging, itching, scaling, and loss of eyelashes are common symptoms of Demodex blepharitis.

Treatment

Your doctor may use an in-office eyelid scrub consisting of 50% tea tree oil to clean your lashes and kill the Demodex mites. In addition, the doctor may prescribe a 5% tea tree oil cream to use at home on the skin around your eyelids. This will prevent mating and/or reinfestation of the mites in the eyelid area. People who receive the 50% tea tree oil eyelid scrub have been found to show significant improvements in their symptoms.

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The material contained on this site is for informational purposes only and is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health care provider.