BSC NURSING III YEAR - MEDICAL SURGICAL NURSING II

1. Mr. Manikandan.T,
RN., RM., M.Sc(N)., D.C.A .,(Ph.D)
Assistant Professor,
Dept. of Medical Surgical Nursing,
VMCON, Puducherry.

2. KERATITIS
• Infection or inflammation of the cornea
caused by a variety of microorganism or by
other factors.
• This condition may involve the conjunctiva /
cornea or both - keratoconjunctivitis

3. Etiology
• Bacterial infection
• Viral infection – herpes simplex, varicella
zoster, adeno virus
• Other causes – fungi (aspergilles, candidiasis),
parasite – acanthamoeba
• Contact lens wear
• Vitamin- A Deficiency
• Cosmetics

4. Clinical manifestation
• Eye redness
• Eye pain
• Excess tears
• Difficulty in opening eyelid
• Blurred vision
• Photophobia
• Foreign body sensation

5. Diagnosis
• H.C
• P/E
• Slit lamp
• Corneal smear
• Pen light exam

6. Management
• Antibiotic eye drops
• Cycloplegic (dilating) drops can be used for
light sensitivity
• Viral – anti viral medication – systemic/
topical (acyclovir), analgesic for pain
• Fungal – anti fungal eye drops (natamycin),
corneal transplantation.

7. Phototherapeutic Keratectomy
• Phototherapeutic keratectomy (PTK) is a laser procedure that is used to treat
diseased corneal tissue by removing or reducing corneal opacities and smoothing
the anterior corneal surface to improve functional vision.
• PTK is a safer, more effective (when indicated) alternative than penetrating or
lamellar keratoplasty.
• PTK is contraindicated in patients
• with active herpetic keratitis because the ultraviolet
• rays may reactivate latent virus. Common side effects are induced
• hyperopia and stromal haze. Complications are delayed
• reepithelization (particularly in patients with diabetes)
• and bacterial keratitis. Postoperative management consists
• of oral analgesics for eye pain. Reepithelization is promoted
• with a pressure patch or therapeutic soft contact lens. Antibiotic
• and corticosteroid ointments and nonsteroidal antiinflammatory
• agents (NSAIDs) are prescribed postoperatively.
• Follow-up examinations are required for up to 2 years.

8. • Tissue loss caused by infection of cornea
produces a corneal ulcer

9. Causes
• Fungi – aspergillus, candida, histoplasma
• Bacteria
• Virus – herpes simplex
• Foreign body
• Scratches on eye surface

10. Clinical features
• Corneal ulcer – dry looking, greyish white
• Pigmented ulcer
• Pain
• Tearing
• Redness
• Photophobia

11. Diagnosis
• H.C
• P/E
• Gram’s – giemsa stained film
• Corneal scraping / corneal biopsy

12. Management
• Topical antifungal eye drops – natamycin,
miconazole
• Avoid eye makeup
• Phototherapeutic Keratectomy - laser
procedure that is used to treat diseased
corneal tissue by removing or reducing
corneal opacities