Keratitis

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keratitis

[‚ker·ə′tīd·əs]
(medicine)
Inflammation of the cornea.

Keratitis

 

inflammation of the cornea of the eye.

Keratitis arises from certain external, predominantly infectious, factors (exogenic keratitis) or from common systemic diseases (endogenic keratitis). Keratitis may also be caused by mechanical, thermal, chemical, or radiation traumas, as well as certain types of vitamin deficiency. Keratitis is manifested by photophobia, epiphora, pain, and redness of the eye, by edema of the cornea and disruption of its transparency (development of an inflammatory infiltrate), and sometimes by loss of sensitivity of the cornea and the appearance of newly formed ingrown blood vessels. The duration and course of keratitis depends on the cause of the inflammation; with infectious keratitis it depends on the type and virulence of the microorganisms and also on the reactivity and condition of the body. Often as a result of keratitis there remain persistent opacities (cataracts), in some cases small and unobtrusive and in others large and intense, which are often the cause of a decrease in vision, especially if they are located in the central, contrapupillary portion of the cornea.

A distinction is made between surface keratites and deep keratitis. The most frequently encountered of the surface exogenic keratites are catarrhal keratitis, which develops from infectious conjunctivitis; herpetic keratitis, the result of viral affection of the eye; keratitis with epidemic adenoviral conjunctivitis; serpiginous corneal ulcer, a serious purulent disease usually caused by a pneumococcal infection and often arising after minor injury to the cornea (the entry of small foreign bodies or scratches); and keratitis with blennorrhea, diphtheria, or trachoma.

Most frequently encountered of the surface endogenic keratites is phlyctenular keratitis as a manifestation of an allergy in children and adolescents with tubercular intoxication; keratitis in this form is usually bilateral and tends to recur. The typical form of deep endogenic keratitis is parenchymatous keratitis with congenital syphilis; it is observed in children and adolescents, is as a rule bilateral, and is characterized by a prolonged course and diffuse infiltration of the cornea, often with ingrown blood vessels; vision, which decreases severely in the beginning, may subsequently improve substantially or even be restored with resorption of infiltrates. Deep keratitis with tuberculosis usually affects one eye and leaves intense opacity of the cornea.

Treatment of keratitis must be directed toward eliminating the cause of the disease; with infectious keratites antibiotics or sulfanilamides are used locally; with cataracts that substantially decrease vision surgical intervention (keratoplasty) is necessary.

REFERENCE

Barbel’, I. E. “Bolezni rogovoi obolochki.” In Mnogotomnoe rukovodstvo po glaznym bolezniam, vol. 2, book 1. Moscow, 1960. (Bibliography.)

M. L. KRASNOV

References in periodicals archive ?
Topical steroids predisposed to microbial keratitis in 26 cases, of whom 50 per cent had fungal aetiology.
ECI's hypothesis is that ECI characterized Protector Proteins alphaA-Crystallin, gammaD-Crystallin and the chimeric protein, pepstatin /leupeptin/alphaA-Crystallin, will inhibit the proteolytic enzymes secreted by the host and the pathogen, thus serving as a good therapeutic agent against the management of microbial keratitis.
Dan Gore, from Moorfields Eye Hospital, will present on keratoconus treatment, and Professor John Dart, from Moorfields Eye Hospital and University College London, will talk on microbial keratitis.
She tempered the potential risk of microbial keratitis in contact lens wearers by revealing that this was far less likely than the risk of retinal detachment in those with moderate myopia.
Bacteria infections cause around 6,000 cases of microbial keratitis annually.
Table 1 Pathologies seen by the rapid access clinic at Bradford Royal Infirmary (* % rounded up to the nearest decimal place) Pathology n % * Blepharitis/dry eye/epitheliopathy 15 15% Microbial keratitis 13 13% Conjunctivitis 9 9% Uveitis 9 9% Abrasion/insult/foreign body 9 9% Vitreoretinal 7 7% Post-operative complications 6 6% Posterior vitreous detachment 6 6% Abrasion/trauma/foreign body 5 5% Disc abnormality (non-glaucoma) 4 4% Wet age-related macular degeneration (AMD) 3 3% Lid lesion 3 3% Episcleritis 3 3% Cataract 2 2% Binocular vision 2 2% Other 7 7% Figure 1 The proportion of patients who could have been seen and managed by a primary care PEARS, IP or could only have been managed in secondary care (HES) (n=103) HES 32% IP 36% PEARS 32% Note: Table made from pie chart.
Of great interest to all eye care practitioners (ECPs) is to maximise safety of contact lens wear for all patients, and in particular, encourage compliance to reduce the risk of microbial keratitis (MK).
Infected infiltrates are caused by microbial keratitis (MK), (Figure 4), a sight-threatening condition which is, unfortunately, associated with contact lens wear.
This means solution sensitivity is far reduced as the lenses are supplied basically in saline and hygiene is potentially improved as bacterial contamination of storage cases is a strong risk factor for microbial keratitis.
Careful consideration was given to a differential diagnosis of early microbial keratitis.
Charting past and current research, she described her work looking at the causes of microbial keratitis, which is now progressing into genetics.
oc: ZOVIRAX 3% QDS Figure 1 Conditions encountered in placement Abrasion 8% Blepharitis 7% Dry Eye 14% Foreign Body 6% Floaters 11% Conjunctivitis 4% HSV 4% Uveitis 6% Glaucoma 1% Microbial keratitis 4% Other 35% Note: Table made from pie chart.

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