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Keratitis and Contact Lens Infections

Herpes keratitis | Dendrite

A keratitis is defined as inflammation of the cornea, the transparent window at the front of the eye. This is a very wide topic and we can only cover an overview.

  • Bacterial Keratitis or Corneal Ulcer happens when the cornea is compromised by a bacteria. This is a sight threatening situation as some bacteria can perforate the cornea is 48 hours. We usually see bacterial keratitis in non compliant contact lens users. Namely, patients who tend to sleep with their contact lenses, not replace them properly have a much higher risk of developing a cornea ulcer. Typically pains arrives rapidly, can be very severe. Patients complain of a foreign body sensation, excess tearing, a lot of light sensitivity. This is a medical emergency that needs to be addressed. Generally, treatment is started empirically with broad spectrum antibiotics eye drops. If the ulcer is not in the center of the cornea, consequences should be minimal. If the corneal ulcer is central, it may leave a corneal scar resulting in permanent vision loss. If you use contact lenses and develop those symptoms, do not wait, call your eye doctor so medical therapy can be started. Our office provides services for eye emergencies. Outside of working hours, we work with a group of ophthalmologists who have an eye doctor on call 24/7. 

  • Viral keratitis : this is a less common event, but when we do see it, the culprit are usually herpes viruses. Both Herpes simplex and Herpes Zoster (shingles) can result in a viral keratitis called herpetic keratitis. Treatment usually involves oral anti-viral medication such as acyclovir or valacyclovir. In some situations, topical anti-inflammatory eye drops, judiciously used, can help with symptoms and outcome. Untreated herpetic eye disease can lead to permanent vision loss

  • Chemical and physical burns: exposure to chemicals in the eye can result in inflammation and tissue damage. This is true for a lot of chemicals, including solvants, acids, bases and alcohol. If you received chemicals in your eyes, rinse thoroughly the eye with water for at least 15 minutes and call your eye doctor or go to the emergency department of your local hospital. Physical burns happens with UV light from the sun, from the lack of use of sunglasses , skiing or on the water. They can also happen in certain categories of workers using machinery like welders.

  • Keratitis, can also happen with dry eye. See our dry eye page

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