7/19/2013 4:26:00 PM Dr. K for July 21, 2013 Eye drops, artificial tears can treat mild keratitis
DEAR DOCTOR K: I have keratitis, for which my doctor has prescribed antibiotic eye drops. How did I get this? How can I avoid it in the future?
DEAR READER: Keratitis is an inflammation of the cornea, the clear dome at the front of the eye that covers the pupil and iris (the colored ring around the pupil). Keratitis can cause red eye, the sensation of something in your eye, pain, light sensitivity, watery eye, blurred vision and difficulty keeping your eyelids open.
Keratitis typically results from infection or injury. Infectious keratitis, typically caused by a bacterial or viral infection, usually begins in the outer layer of the cornea, but it can go deeper into the cornea. If it does go deeper, it can cause permanent injury to the cornea, and that can make your vision worse. Infectious keratitis can also occur after an injury to the cornea. The injury can weaken the defenses that protect your eye against infection.
An injury can inflame the cornea even if an infection never sets in. Injury may be caused by scratching your eye or wearing poorly fitting contact lenses. Some autoimmune diseases, including rheumatoid arthritis and Sjogren's syndrome, also cause keratitis.
Treatment depends upon the cause. If there is only mild injury to the cornea, no treatment is necessary.
Since your doctor has prescribed antibiotic eye drops, you probably have keratitis caused by a bacterial infection. For more severe bacterial infections, doctors sometimes also prescribe oral antibiotics.
If keratitis is caused by a virus, you would need antiviral eye drops, an antiviral oral medication, or both.
Artificial tears usually are effective for keratitis related to dry eyes. And corticosteroid eye drops, which ease inflammation, are often prescribed for keratitis caused by an autoimmune disease. Treating the underlying disease also helps.
To prevent keratitis: -- Avoid eye injury by wearing sunglasses and appropriate eye gear as needed.
-- If you have a cold sore, do not put your fingers to your eyes. The same virus that causes cold sores can cause keratitis.
-- If you use contact lenses, wear and care for them properly. Stop wearing them if you suspect you are developing an eye infection.
-- Use moisturizing eye drops.
"Red eye" is a pretty common problem. Usually it's mild, people don't call their doctor, and it goes away. However, there are other eye conditions besides keratitis that can cause red eyes, and some of them need urgent medical attention.
A few symptoms, in particular, raise "red flags." When you have them, along with a red eye, you should call your doctor immediately. They include difficulty seeing things clearly (near or far), pain in the eye, a bad headache located in and around the eye, and nausea or vomiting. These symptoms can indicate that you have a condition more serious than keratitis, such as acute glaucoma or uveitis, and you need immediate evaluation and treatment.
(Dr. Komaroff is a physician and professor at Harvard Medical School. To send questions, go to AskDoctorK.com, or write: Ask Doctor K, 10 Shattuck St., Second Floor, Boston, MA 02115.)