This document discusses keratitis, an infection or inflammation of the cornea caused by various microorganisms or other factors. It can involve just the cornea or both the cornea and conjunctiva. Causes include bacterial, viral, fungal infections, contact lenses, vitamin A deficiency, cosmetics. Symptoms are eye redness, pain, tearing, blurred vision, photophobia. Diagnosis involves examination with a slit lamp and corneal smears. Treatment consists of antibiotic eye drops, antiviral medications, antifungal drops, cycloplegic drops, and phototherapeutic keratectomy using laser treatment for diseased corneal tissue.

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