Symptoms, causes, classification and treatment methods for keratitis

Keratitis is an inflammatory disease that is localized in the cornea of ​​the eye. This disease is characterized by unpleasant symptoms, but thanks to the achievements of modern medicine, it is highly treatable; the main thing is to seek qualified medical help in time.

The cornea is the most important part of the so-called optical system of the eye, responsible for visual effects. The cornea is the front transparent layer of the eye. The clarity of vision and its acuity largely depend on the condition of the cornea. There is a set of parameters of the cornea that ophthalmologists measure: surface curvature, structure, transparency, sphericity and others. Due to the inflammation that occurs with keratitis, changes may occur in the cornea. These changes cannot always be corrected by treatment - they can be irreversible. Therefore, it is important to consult a doctor in time and start therapy as early as possible so as not to worsen the problem.

At CELT you can get advice from an ophthalmologist.

  • Initial consultation – 3,900
  • Repeated consultation – 2,000

Make an appointment

General information

The cornea is a relatively dense, transparent layer that protects the front, exposed surface of the eyeball. Both the shape of the cornea (it should be as flat, smooth, spherical as possible) and its transparency are of key importance, since any optical interference - turbidity, inhomogeneous inclusions, scars, etc. - distorts the normal refraction of light and/or reduces its intensity on the way to the retina inevitably affects the quality of the final visual image. Unlike some other inflammatory processes of the eye (blepharitis, conjunctivitis), which may not significantly affect visual acuity, with keratitis there is almost always a decrease in visual function. That is why it is extremely important to begin treatment as soon as possible, before irreversible scar changes form on the main optical axis of the eye.

Our services in ophthalmology:

The administration of CELT JSC regularly updates the price list posted on the clinic’s website. However, in order to avoid possible misunderstandings, we ask you to clarify the cost of services by phone: +7

Service namePrice in rubles
Appointment with an ophthalmologist (primary)3 900
Appointment with a surgical doctor (repeated, for complex programs) within 3 months after the initial one2 000
Ultrasound scanning of the anterior segment of the eye1 000
Removal of foreign bodies of the cornea, conjunctiva2 000

All services

Make an appointment through the application or by calling +7 +7 We work every day:

  • Monday—Friday: 8.00—20.00
  • Saturday: 8.00–18.00
  • Sunday is a day off

The nearest metro and MCC stations to the clinic:

  • Highway of Enthusiasts or Perovo
  • Partisan
  • Enthusiast Highway

Driving directions

Types and types of keratitis

In publications you can often find a division of keratitis into exogenous (caused by external influences) and endogenous (caused by internal factors present in the body). However, such a classification seems too general and not entirely successful; It is unclear, for example, to which class allergic keratitis associated with wearing contact lenses should be classified: on the one hand, the allergic reaction is caused by internal immune disorders, on the other, by an external, artificial object.

According to the dynamics of development and type of course, acute and chronic keratitis are distinguished; as a variant of the second type, recurrent keratitis is sometimes considered separately.

The depth of spread of the inflammatory process is essential: superficial keratitis is much less dangerous than deep keratitis, in which the inner corneal layers are scarred.

According to the degree of severity, keratitis is usually divided into mild, moderate and severe; according to the localization of inflammation - central and peripheral.

However, the most convenient and intuitive is the etiological classification, where keratitis is grouped according to the direct causes of the inflammatory process.

Causes of the disease

The main factors of corneal inflammation include:

  • eye injuries, incl. chemical, physical, mechanical damage (foreign body, ultraviolet burn from the blinding light of an electric welding arc, intense solar radiation, etc.);
  • infections (viral, bacterial, fungal);
  • allergic reactions, incl. severe seasonal, drug, onchocerciasis allergies.

Actually, onchocerciasis keratitis, although it is more often classified as allergic, is essentially parasitic, since the allergenic toxin is produced by helminths from the filaria family. Similarly, the very common infectious-allergic keratitis when wearing contact lenses is most often caused not by the lenses as such, but by non-compliance with the rules of hygiene and care for them, as a result of which the cornea becomes infected.

More rare forms are neurogenic keratitis, keratitis due to hypo- or vitamin deficiency, as well as idiopathic keratitis (for example, the so-called filamentous), the causes of which have not yet been reliably established.

Symptoms and signs

Almost all types and types of keratitis are characterized by the so-called. corneal syndrome, including increased lacrimation, increased sensitivity to light and uncontrolled closure of the eyelids (blepharospasm). As a rule, redness is pronounced, the vascular network becomes noticeable, and in severe cases, neovascularization (vascular neoplasms) occurs. The pain can be quite intense. The corneal layer swells, the surface loses its smoothness and often ulcerates (sometimes with a tendency to peel off), and infiltrates appear. Cloudiness of the cornea becomes one of the main symptoms and complaints with keratitis, since the opacity or translucency of the cornea has an extremely negative effect on the acuity and clarity of vision.

Keratitis is often accompanied by concomitant symptoms, the severity of which varies from mild to moderate discomfort (dry nasal and oral mucosa, headache, difficulty swallowing) to severe complications from the periodontium, gastrointestinal tract, etc. Various types of keratitis are characterized by their own specific features.

Clinical picture

The clinical picture of keratitis is a series of manifestations specific to this disease, which have received a special name - corneal syndrome.

It includes symptoms:

  • increased lacrimation;
  • photophobia;
  • narrowing of the palpebral fissure, it is impossible to open the eye completely;
  • eye pain;
  • sensation of a foreign object in the eye;
  • redness of the eye.

In severe cases, the inflammatory process spreads to other parts of the eye and affects the sclera and iris. Another possible complication is ulceration at the site of inflammation. It can lead to perforation, in which infection enters the deep structures of the eye.

Viral keratitis

Keratitis caused by viruses is often accompanied by a blistering rash. The pathogenic agent can be almost any aggressive virus (measles, chickenpox, adenoviruses), but most often it is the herpes virus. As is known, over 95% of the population is infected with herpes infection, and in most cases, herpes occurs latently, in an asymptomatic form, and is activated only when immune resources are weakened, general exhaustion of the body and other unfavorable conditions. In this case, inflammation of the cornea is usually preceded by typical herpetic symptoms - rashes on the lips or other mucous membranes. With herpetic keratitis, as a rule, swelling and the appearance of fuzzy, vague infiltrates predominate.

Bacterial keratitis

Keratitis can be caused by a variety of pathogenic microorganisms, primarily cocci (Staphylococcus aureus, Streptococcus, Gonococcus) and Pseudomonas aeruginosa. A rare and very dangerous infection, even resulting in blindness, is acanthamoeba infection (named after the causative agent Acanthamoeba), which can exist, in particular, in the gap between the contact lens and the surface of the cornea. With the development of the so-called creeping corneal ulcers caused by gonococcal, tuberculosis, syphilitic and other bacterial infections, the risk of rapid and irreversible loss of vision is also very high.

Keratoconus

A condition of the cornea in which its shape is significantly changed in the form of a cone-shaped protruding central zone (see.


). More often it occurs as a congenital anomaly, often combined with other developmental anomalies of the eyes and various organs. But it can also be acquired. Develops at the age of 15-20 years, progresses slowly, vision decreases gradually. At the apex of the cone, Descemet's membrane can rupture and then, due to the penetration of moisture into its tissue, the stroma of the cornea becomes cloudy. The diagnosis of keratoconus is made on the basis of biomicroscopy, ophthalmometry, refractometry, and keratometry. With keratoconus, pronounced astigmatism is detected and often irregular. Corrected with contact lenses in case of malignant disease (see.


) patients require surgical treatment - corneal transplantation.

Treatment of the disease

Almost all special sources emphasize the dangers of self-diagnosis and self-medication. The fact is that it is almost impossible for a non-specialist to distinguish incipient keratitis from “ordinary” conjunctivitis, and the bacterial form, for example, from a fungal one. Meanwhile, therapy in each case should be aimed at eliminating the primary pathogenic factor.

Thus, viral infections require stimulation of the immune response with interferon preparations (or medications that promote its production in the body) or antiviral agents. These include: Oftalmoferon, Poludan, Acyclovir, etc.

For bacterial infections, treatment with antibiotics is necessary, and their choice, dosage, and duration of treatment should correspond as closely as possible to the type and sensitivity of the pathogen. Typically, ophthalmologists prescribe medications in the form of Vitabact, Levomycetin, Tsipromed eye drops or ointments (Tetracycline, Floxal, Tobrex, Erythromycin eye ointment).

Fungal infections of the cornea usually require much longer treatment compared to other forms, and include specific antimycotic drugs based on fluconazole, natamycin, amphotericin, etc.

The main method of relieving allergic reactions are drugs that suppress the secretion of histamine and reduce the reactivity of H1 receptors. The most well-known and widely used antiallergic drug since the mid-90s remains loratadine (and numerous generic medications based on it). Basic antiallergic drops: Opatanol, Lecrolin, Allergodil.

As additional therapy aimed at relieving general inflammatory symptoms, vasoconstrictors, moisturizers, hormonal and non-steroidal anti-inflammatory drugs can be prescribed. Physiotherapeutic methods (laser irradiation of the cornea, electrophoresis of drugs) are actively used.

However, the main factors of therapeutic success in the treatment of keratitis, which allow preserving vision and preventing chronification of the process, the development of severe complications, and involvement of the deep layers of the cornea, are:

  • timely seeking help, refusal to attempt self-medication;
  • reliable differential diagnosis in order to establish the causes of inflammation, the type of pathogen, the severity and localization of the process;
  • adequate etiopathogenetic therapy aimed at eliminating the pathogenic factor.

By contacting our ophthalmology center, you are guaranteed to receive high-quality diagnostics and effective treatment of diseases by recognized specialists using high-tech equipment! Remember: keratitis is a serious disease that can lead to the most severe consequences, including permanent loss of vision.

Corneal dystrophies

Corneal dystrophies are divided into primary (congenital) and secondary (acquired). Primary dystrophies are caused by metabolic disorders, mainly of protein metabolism, they require systematic inpatient monitoring in the ophthalmology department (see.


, cm.


). Secondary corneal dystrophies develop in connection with local processes in the eye (trauma, burns, infectious lesions of the cornea, glaucoma) and with pathology of collagen tissue. Secondary dystrophies also include edematous forms of dystrophy (bullous keratopathy, epithelial endothelial corneal dystrophy), which develop in response to damage to the corneal endothelium during cataract extraction (removal).


).

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