Dr. Niteen Dedhia
August 20, 2020 | Author: Admin
August 20, 2020
Introduction
Bacterial keratitis is the condition caused due to the attack of bacteria on the cornea. There are
various causes of bacterial infection. The treatment should be started as soon as possible to
prevent vision loss.
What Is Bacterial Keratitis?
The cornea is a clear and transparent layer in the front part of the eye. Bacterial keratitis is the
infection of the cornea caused by bacteria . If not treated at an early stage, it may result in severe
complications. The condition is progressive and may lead to blindness. The most common
bacteria responsible for causing bacterial keratitis are Pseudomonas aeruginosa and
Staphylococcus aureus.
Bacterial keratitis follows different stages from infection to healing. These stages include
progressive infiltration, phase of ulcer formation, the regression stage, and finally, the healing
stage.
What Are The Symptoms Of Bacterial Keratitis?
Following are some of the symptoms of Bacterial Keratitis:
- Sudden eye pain
- Eye Redness
- Reduced vision
- Increased light sensitivity
- Eyelid edema
- Watery eyes
- Mucopurulent discharge
What Are The Causes Of Bacterial Keratitis?
Following are some of the causes of bacterial keratitis:
Contact lens: Improper care of the contact lens is considered as one of the most common
causes of bacterial keratitis. Swimming with the contact lens and wearing the lens overnight
increases the risk of bacterial keratitis.
Contaminated ocular medications: Administering contaminated ocular medications or the
medication after the expiry may lead to bacterial keratitis.
Immunosuppressive drugs: Immunosuppressive drugs reduce the activity of the immune
system and thus, makes the person more vulnerable to infection.
Underlying corneal diseases: Corneal diseases, such as neurotrophic keratopathy, increases
the risk of bacterial keratitis.
Reduced immune defense: The immune defense may be reduced due to various reasons. It
results in an increased risk of infection.
Aqueous deficient dry eye: People who have aqueous deficient dry eye are also vulnerable to
bacterial keratitis.
Corneal injury: Corneal injury or corneal trauma such as previous corneal injury due to foreign body either metallic or non metallic or due to contact sports or chemical exposure, risk of bacterial keratitis increases.
How The Diagnosis Of Bacterial Keratitis Done?
Diagnosis of bacterial keratitis is done through the following methods:
History: The doctor will ask about your history of contact lens use, any ocular injury, previous
corneal surgery, or the use of immunosuppressive drugs. The doctor asks in detail about the
change of the contact lens and the cleaning procedure of the contact lens. Based on your
history, the doctor may further perform the physical examination of the eye.
Physical examination: The ophthalmologist will perform the comprehensive physical
examination of the eye. It includes visual acuity, pupil examination, determination of
intraocular pressure, and slit-lamp examination. The ophthalmologist may rule out the
presence of other conditions that are causing the symptoms.
Corneal scraping: The doctor may take the corneal scraping for culture of tissue for organisms to determine the presence of any bacteria.
What Are The Treatment Options For Bacterial Keratitis?
Following are the treatment options for bacterial keratitis:
Medications: Various medications are prescribed for bacterial keratitis. The treatment regimen
depends upon the types of causative organisms and the severity of the condition. Treatment
includes the fluoroquinolone eye drops such as ciprofloxacin or moxifloxacin, tobramycin, and
vancomycin. It could be in drop form or ointment or sub conjunctival injection. The drops may need to be prepared in the fortified form in severe infections.
Follow-up: The follow-up is very important to look for the effect of antibiotics. If the antibiotic
does not improve the symptoms, the addition of another antibiotic is usually recommended.
Once the infection starts healing, it is advised to taper the antibiotics.
What Are The Complications Of Bacterial Keratitis?
Following are some of the complications of bacterial keratitis:
- Scleral extension of the infection
- Loss of vision
- Corneal perforation
- Endophthalmitis
- Residual corneal scarring
- Permanently reduced vision
