Mr. Manikandan.T,
RN., RM., M.Sc(N)., D.C.A .,(Ph.D)
Assistant Professor,
Dept. of Medical Surgical Nursing,
VMCON, Puducherry.
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
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
Clinical manifestation
• Eye redness
• Eye pain
• Excess tears
• Difficulty in opening eyelid
• Blurred vision
• Photophobia
• Foreign body sensation
Diagnosis
• H.C
• P/E
• Slit lamp
• Corneal smear
• Pen light exam
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.
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.
• Tissue loss caused by infection of cornea
produces a corneal ulcer
Causes
• Fungi – aspergillus, candida, histoplasma
• Bacteria
• Virus – herpes simplex
• Foreign body
• Scratches on eye surface
Clinical features
• Corneal ulcer – dry looking, greyish white
• Pigmented ulcer
• Pain
• Tearing
• Redness
• Photophobia
Diagnosis
• H.C
• P/E
• Gram’s – giemsa stained film
• Corneal scraping / corneal biopsy
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

Corneal disorder

  • 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 orinflammation 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 • Eyeredness • 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 eyedrops • 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 • Phototherapeutickeratectomy (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 losscaused 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 • Cornealulcer – 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 antifungaleye drops – natamycin, miconazole • Avoid eye makeup • Phototherapeutic Keratectomy - laser procedure that is used to treat diseased corneal tissue by removing or reducing corneal opacities