Diagnosis

Diagnosing keratitis typically involves the following:

  • Eye exam. Although it may be uncomfortable to open your eyes for the exam, it's important that your doctor examines your eyes. The exam will include how well you can see (visual acuity).
  • Penlight exam. Your doctor may examine your eye using a penlight, to check your pupil's reaction, size and other factors. Your doctor may apply a stain to the surface of your eye, to help identify the extent and character of surface irregularities and ulcers of the cornea.
  • Slit-lamp exam. Your doctor will examine your eyes with a special instrument called a slit lamp. It provides a bright source of light and magnification to detect the character and extent of keratitis, as well as the effect it may have on other structures of the eye.
  • Laboratory analysis. Your doctor may take a sample of tears or some cells from your cornea for laboratory analysis to determine the cause of keratitis and to help develop a treatment plan for your condition.

Treatment

Noninfectious keratitis

Treatment of noninfectious keratitis varies depending on the severity. For example, with mild discomfort from a corneal scratch, artificial tear drops may be the only treatment. However, if keratitis is causing significant tearing and pain, a 24-hour eye patch and topical eye medications may be necessary.

Infectious keratitis

Treatment of infectious keratitis varies, depending on the cause of the infection.

  • Bacterial keratitis. For mild bacterial keratitis, antibacterial eyedrops may be all you need to effectively treat the infection. If the infection is moderate to severe, you may need to take oral antibiotics to get rid of the infection.
  • Fungal keratitis. Keratitis caused by fungi typically requires antifungal eyedrops and oral antifungal medication.
  • Viral keratitis. If a virus is causing the infection, antiviral eyedrops and oral antiviral medications may be effective. Other viruses need only supportive care such as artificial tear drops.
  • Acanthamoeba keratitis. Keratitis that's caused by the tiny parasite acanthamoeba can be difficult to treat. Antibiotic eyedrops are used, but some acanthamoeba infections are resistant to medication. Severe cases of acanthamoeba keratitis may require a cornea transplant.

If keratitis doesn't respond to medication, or if it causes permanent damage to the cornea that significantly impairs your vision, your doctor may recommend a cornea transplant.

Clinical trials

Explore Mayo Clinic studies testing new treatments, interventions and tests as a means to prevent, detect, treat or manage this disease.

Preparing for your appointment

You may start by seeing or calling your family doctor or a general practitioner if you have eye-related signs or symptoms that worry you. Depending on the type and severity of your symptoms, your doctor may refer you to an eye specialist (ophthalmologist). Because appointments can be brief, and because there's often a lot to talk about, it's a good idea to be well-prepared.

What you can do

  • Be aware of any pre-appointment restrictions when you make the appointment. Ask if there's anything you need to do in advance, such as stop wearing contact lenses or discontinue using eyedrops.
  • Write down any symptoms you're experiencing, including any that may seem unrelated to the reason for which you scheduled the appointment.
  • Make a list of all medications, including vitamins and supplements that you're taking.
  • Write down questions to ask your doctor.

Your time with your doctor is limited, so preparing a list of questions can help you make the most of your time together. List your questions from most important to least important in case time runs out. For keratitis, some basic questions to ask your doctor include:

  • What is likely causing my symptoms?
  • What are other possible causes for my symptoms?
  • What kinds of tests do I need?
  • What is the best course of action?
  • What are the alternatives to the approach you're suggesting?
  • I have other health conditions. How can I best manage them together?
  • Are there any restrictions that I need to follow?
  • Should I see a specialist? What will that cost, and will my insurance cover it?
  • Is there a generic alternative to the medicine you're prescribing?
  • Are there any brochures or other printed material that I can take with me? What websites do you recommend?
  • What will determine whether I need to be seen for a follow-up visit?

In addition to the questions you've prepared, don't hesitate to ask your doctor other questions anytime you don't understand something.

What to expect from your doctor

Your doctor is likely to ask you a number of questions. Being ready to answer them may allow time later to cover points you want to address. Your doctor may ask:

  • When did you begin experiencing symptoms?
  • Have your symptoms been continuous or occasional?
  • How severe are your symptoms?
  • What, if anything, seems to improve your symptoms?
  • What, if anything, appears to worsen your symptoms?
  • Has your eye been injured recently?
  • Have you been swimming or been in a hot tub recently?
  • Do your symptoms affect one eye or both eyes?
  • Do you use contact lenses?
  • Do you sleep in your contact lenses?
  • How do you clean your contact lenses?
  • How often do you replace your contact lens storage case?
  • Have you had a similar problem in the past?
  • Are you using eyedrops now or have you used any recently?
  • How is your general health?
  • Have you ever had a sexually transmitted infection?
  • Are you taking prescription medications or supplements?
  • Have you recently changed the type of cosmetics that you are using?
Nov. 08, 2018
References
  1. Keratitis. American Academy of Ophthalmology. https://www.aao.org/eye-health/diseases/what-is-keratitis. Accessed Sept. 18, 2018.
  2. Yanoff M, et al., eds. Bacterial keratitis. In: Ophthalmology. 4th ed. Edinburgh, U.K.: Mosby Elsevier; 2014. https://www.clinicalkey.com. Accessed Sept. 18, 2018.
  3. Basics of bacterial keratitis. Centers for Disease Control and Prevention. https://www.cdc.gov/contactlenses/bacterial-keratitis.html. Accessed Sept. 18, 2018.
  4. Cherry JD, et al., eds. Ocular infections. In: Feigin and Cherry's Textbook of Pediatric Infectious Diseases. 8th ed. Philadelphia, Pa.: Elsevier; 2019. https://www.clinicalkey.com. Accessed Sept. 18, 2018.
  5. Jacobs DS. Evaluation of the red eye. https://www.uptodate.com/contents/search. Accessed Sept. 18, 2018.
  6. Austin A, et al. Update on the management of infectious keratitis. Ophthalmology. 2017;124:1678.
  7. What is bacterial keratitis? American Academy of Ophthalmology. https://www.aao.org/eye-health/diseases/what-is-bacterial-keratitis. Accessed Sept. 18, 2018.
  8. Basics of HSV (herpes simplex virus) keratitis. Centers for Disease Control and Prevention. http://www.cdc.gov/contactlenses/viral-keratitis.html. Accessed Sept. 18, 2018.
  9. Softing Hataye AL (expert opinion). Mayo Clinic, Rochester, Minn. Oct. 27, 2018.