keratitis

Question 1

what is keratitis?

Answer 1

inflammation of the cornea

Question 2

why is microbial keratitis different from conjunctivitis?

Answer 2

microbial keratitis is potentially sight threatening and should therefore be urgently evaluated and treated

Question 3

what are the causes of keratitis?

Answer 3

• bacterial
  
  • _{S. aureus}
  • _{P. aeruginosa in contact lens wearers}
• fungal
• amoebic
  
  • _{acanthamoebic keratitis (5%)}
  • _{increased incidence if eye exposure to soil/contaminated water}
• parasitic
  
  • _{onchocercal keratitis (‘river blindness’)}

Question 4

what are other factors that may cause keratitis?

Answer 4

• viral
  
  • _{herpes simplex keratitis}
• environmental
  
  • _{photokeratitis}
  • _{exposure keratitis}
  • _{contact lens acute red eye (CLARE)}

Question 5

what are the clinical features of keratitis?

Answer 5

• red eye: pain and erythema
• photophobia
• foreign body, gritty sensation
• hypopyon may be seen

Question 6

how should you assess contact lens wearers who present with a painful red eye?

Answer 6

same day referral to eye specialist to rule out microbial keratitis

accurate dx by slit-lamp

Question 7

how is microbial keratitis managed?

Answer 7

1. stop using contact lens until sx fully resolved
2. topical abx
   
   • quinolones 1st line
3. cycloplegics for pain relief
   
   • e.g. cyclopentolate

Question 8

what are the complications of microbial keratitis?

Answer 8

1. corneal scarring
2. perforation
3. endophthalmitis
4. visual loss