Infectious Keratitis: A Guide to Symptoms and Treatment

Written by Medicover Team and Medically Reviewed by Dr Manaswini Priya Varanasi , Ophthalmologists

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1. Causes 2. Find a Doctor 3. Diagnosis 4. Treatment 5. FAQs

Infectious keratitis is an eye condition characterized by the inflammation and infection of the cornea, the clear dome-shaped tissue covering the front of the eye. This condition is usually caused by bacteria, viruses, fungi, or parasites that enter the eye through a scratch, injury, or contact with contaminated objects. The cornea, being a vital part of vision, is vulnerable to infections that can lead to discomfort and vision problems if not promptly treated.

Proper hygiene, such as avoiding touching the eyes with dirty hands and using clean contact lenses, can help prevent infectious keratitis. If you suspect you have an eye infection or experience any discomfort, it's essential to seek medical attention from an eye care professional for evaluation and appropriate management.

What Are the Types of Infectious Keratitis?

Infectious keratitis encompasses various types of eye infections that affect the cornea, the clear outer layer of the eye. Common types include bacterial keratitis, caused by bacteria like Staphylococcus aureus or Pseudomonas aeruginosa; viral keratitis, often due to herpes simplex virus or varicella-zoster virus; fungal keratitis, resulting from fungi such as Fusarium or Candida; and parasitic keratitis caused by microorganisms like Acanthamoeba.

Each type presents with distinct symptoms and requires specific treatments tailored to the causative agent, highlighting the importance of accurately diagnosing the underlying infection for effective management.

Bacterial keratitis is commonly caused by Staphylococcus aureus or Pseudomonas aeruginosa.
Fungal keratitis is often associated with trauma involving plant material or contact lens wear.
Acanthamoeba keratitis is typically linked to contaminated water sources, such as swimming pools or hot tubs.
Viral keratitis can be caused by herpes simplex virus (HSV) or varicella-zoster virus (VZV).
Parasitic keratitis is rare but can occur due to infections like microsporidia or nematodes.

What Are the Symptoms of Infectious Keratitis?

Infectious keratitis can cause symptoms like eye redness, pain, light sensitivity, blurred vision, and excessive tearing. You may also experience a feeling of something in your eye, discharge, or changes in the color of your iris. If you notice any of these symptoms, especially after an eye injury or wearing contact lenses, it's essential to seek prompt medical attention.

Early diagnosis and treatment are crucial to prevent complications and promote speedy recovery. Remember, your eye health is vital, so don't hesitate to reach out to your eye care provider if you have any concerns.

Redness, pain, and increased sensitivity to light are common symptoms of infectious keratitis, often accompanied by excessive tearing.
Blurred vision or difficulty seeing clearly, especially in one eye, can be a sign of infectious keratitis.
Eye discharge, which may be watery, yellow, or pus-like, is a frequent symptom of infectious keratitis.
Feeling like there's something in your eye or experiencing foreign body sensation is a typical complaint in infectious keratitis cases.
Eye redness that doesn't improve with over-the-counter eye drops and worsens over time could indicate infectious keratitis.

What Causes Infectious Keratitis?

Bacteria like Staphylococcus aureus and Pseudomonas aeruginosa are frequent culprits, especially in contact lens wearers with poor hygiene practices. Viral infections, such as herpes simplex virus, can also trigger keratitis episodes. Fungal keratitis often occurs in agricultural or tropical regions due to exposure to plant material or trauma.

Parasitic infections, although less common, can result from poor sanitation or contact with contaminated water sources. Proper eye care and hygiene are crucial in preventing infectious keratitis.

Bacterial infections, such as those caused by Staphylococcus aureus or Pseudomonas aeruginosa, can lead to infectious keratitis.
Fungal keratitis may result from exposure to fungi like Fusarium or Aspergillus, commonly found in soil or organic matter.
Viral infections, including herpes simplex virus (HSV) or varicella-zoster virus (VZV), can trigger keratitis, especially in immunocompromised individuals.
Parasitic keratitis, caused by organisms like Acanthamoeba, can occur from contaminated water exposure, such as swimming or using contact lenses.
Microbial keratitis can also be caused by improper contact lens hygiene, leading to colonization of bacteria or

When Should You See a Doctor for Infectious Keratitis?

Consult an Ophthalmologist (Eye Specialist) immediately if you experience severe eye pain, redness, blurred vision, light sensitivity, or discharge, especially after wearing contact lenses or sustaining an eye injury. Early treatment can help prevent permanent vision loss.

Severe eye pain or redness
Blurred or decreased vision
Light sensitivity
Excessive tearing or eye discharge
White spot on the cornea
Symptoms after eye injury or contact lens use

Prompt diagnosis and treatment help prevent corneal scarring, vision loss, and other serious eye complications.

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How Is Infectious Keratitis Diagnosed?

The initial assessment may include a detailed patient history to identify potential risk factors such as contact lens use or recent eye trauma. Ophthalmic tests such as a slit-lamp examination and corneal cultures are commonly performed to assess the severity and causative organism of the infection.

In some cases, additional imaging studies like anterior segment optical coherence tomography (OCT) may be utilized to evaluate the extent of corneal involvement. These diagnostic methods help clinicians to accurately diagnose infectious keratitis and determine the most appropriate treatment approach for the patient.

Physical examination of the eye by an ophthalmologist.
Corneal scraping for microbiological analysis.
In vivo confocal microscopy to visualize corneal layers.
Culturing of corneal samples to identify specific pathogens.
Polymerase chain reaction (PCR) testing for rapid pathogen detection.
Fluorescein staining to highlight corneal abrasions.
Anterior segment optical coherence tomography (OCT) for detailed imaging.
Sensitivity testing to determine appropriate antimicrobial therapy.

How Is Infectious Keratitis Treated?

Treatment for infectious keratitis aims to eliminate the infection, relieve symptoms, and protect vision. The treatment depends on the underlying cause and the severity of the infection.

Antibiotic eye drops for bacterial infections
Antifungal medications for fungal keratitis
Antiviral medications for viral keratitis
Antiparasitic medications for Acanthamoeba infections
Corneal surgery or transplantation in severe cases
Regular follow-up with an ophthalmologist

Early treatment helps prevent vision loss, reduce complications, and promote faster recovery.

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What Are the Risk Factors for Infectious Keratitis?

Several factors increase the risk of developing infectious keratitis by making the cornea more vulnerable to infection. Recognizing these risks can help protect your eye health.

Contact lens wear, especially extended wear, increases the risk of developing infectious keratitis due to decreased oxygen supply to the cornea.
Trauma to the eye, such as scratches or foreign bodies, can introduce pathogens and lead to infectious keratitis.
Poor hygiene practices, like not properly cleaning and storing contact lenses, can introduce bacteria and fungi that cause infectious keratitis.
Immunosuppression, whether due to certain medications or medical conditions, can weaken the body's ability to fight off infections like keratitis.
Pre-existing ocular surface diseases like dry eye syndrome can compromise the cornea's integrity and make it more susceptible to infections like keratitis.