Are Your Eyes at Risk for Keratitis?

Rosemary Black

Reviewed by QualityHealth's Medical Advisory Board

Do your eyes hurt? If you’re sensitive to light and tearing up, feel discomfort, redness, or pain or are experiencing blurry vision, you may have keratitis.

"Keratitis is a general term for any inflammation of the cornea," says Peter McGannon, MD, of the Cleveland Clinic. The cornea is the clear dome that covers the colored part of your eye. He continues, "Keratitis is a common problem that can have multiple causes," namely microorganisms like bacteria, viruses, and fungi.

Bacterial Keratitis: Contact Lens Wearers Beware

McGannon notes, "While you can develop keratitis from other conditions, one of the biggest groups at risk are people who wear contact lenses," who are more likely to develop the bacterial form of the disease. Bacteria like Pseudomonas, found in soil and water, and Staphylococcus aureus (staph), which live on the body’s skin and mucous membranes, are common culprits. Fortunately, the condition can’t be transmitted from person to person through normal contact.

Bacterial keratitis can develop if you fall asleep wearing your contact lenses, rinse your lenses in water, occasionally forget to clean your contact lens case, or try to extend the life of your two-week contacts to three weeks or a month in order to save money. In this case, "The surface of your eye may not be getting enough oxygen, and proteins that build up on the surface of the lens can scratch the cornea," McGannon says. "Bacteria have a pathway to get into the cornea, and your eye becomes infected."

Risk Factors and Other Kinds of Keratitis

Bacterial keratitis isn’t the only form of this condition; there’s also dry eye or superficial keratitis, which is caused by dry eyes. People with autoimmune conditions are particularly at risk, and "We recommend that people get evaluated for an underlying condition if they have severe dry eyes," says Lisa Park, MD, Clinical Associate Professor and Associate Director of Residency Training at NYU Medical Center, and chief of staff at Bellevue Hospital in New York City. "In some cases, an autoimmune condition like Sjogren’s syndrome [which affects the body’s moisture-producing glands, such as the eyes and mouth] can cause dry eyes and dry eye keratitis."

If you’re a menopausal woman, you should also be wary: "That’s because dry eyes are very common for women in menopause, and dry eyes can cause keratitis," McGannon says.

There’s also viral keratitis, caused by HSV, or Herpes Simplex Virus, and fungal keratitis, which is more common following trauma to the eye, or when there is underlying eye disease.

Diagnosing Keratitis

The symptoms listed above are warning signs of keratitis, but luckily "Keratitis is not one of those things that for the most part, you don’t know that you have," McGannon says. "It’s not like you’re just walking around and everything feels normal."

Non-contact lens wearers are more likely to be proactive when faced with symptoms of keratitis. As Park points out, "Someone who doesn’t wear contacts may feel like they have something in their eye, or their eyes are red and irritated, so they will seek medical attention quickly." However, "Often people who wear contacts are used to putting a foreign body in the eye, so they don’t necessarily react quickly when they have a problem."

Park emphasizes that it’s important to see your eye doctor quickly if you feel anything out of the ordinary about your eyes: "When there is a problem with keratitis, things can degenerate very quickly," she says. "And an infection could ultimately result in scarring or perforation [a hole] of the eye."

Treating Keratitis

If you have keratitis, you’ll be given eye drops—antibiotic drops for bacterial keratitis, anti-fungal drops for the fungal version, and antiviral drops or pills for viral keratitis. If your keratitis is due to dry eyes, you’ll be told to use artificial tears to keep them moist and healthy. In some situations, keratitis may be treated with steroids.

4 Tips to Keep Your Eyes Healthy

Here are four tips for keeping your peepers in peak condition:

Don’t touch your eyes or the area around your eyes until you’ve washed your hands thoroughly. This is especially important if you have a cold sore or herpes blister.
Always wash and dry your hands thoroughly before handling your contact lenses.
Only use eye drops that your doctor prescribes or recommends.
Unless your doctor says it’s okay, don’t fall asleep with your contact lenses in.

Peter McGannon, MD, reviewed this article.