Who was cured of eye keratitis. Treatment of viral and herpetic keratitis. Keratitis: what is it

Keratitis is localized in the anterior part of the eye, or rather in its cornea. Often it is a consequence of previous inflammation of the eyes (, and others). The causative agents are various bacteria (cocci, Pseudomonas aeruginosa, amoeba), viruses (herpes) and fungi. high risk the occurrence of keratitis have persons who wear contact lenses, so such people need to carefully monitor their personal eye hygiene.

Keratitis is occupational disease welders, when working, their eyes are exposed to artificial UV radiation, which often becomes the cause of the disease. With timely and properly selected treatment, the outcome of the disease is quite favorable, but in advanced cases a permanent irreversible decrease in vision, up to blindness, can develop.

The reasons

There are many reasons for the development of keratitis. They are exogenous and endogenous. Sometimes it is not possible to find out the cause of this disease.

Exogenous (outside action) causes include:

• mechanical damage;
• chemical impact;
• thermal impact;
• infections (, syphilitic keratitis);
• fungal infections;
• bacteria (staphylococci, Pseudomonas aeruginosa);
• contact lenses;
• photokeratitis (found in professional welders).

Endogenous (action from within) causes include:

• violation of innervation;
• avitaminosis;
• viruses (herpes);
• metabolic disease;
• disruption of the lacrimal glands;
• diseases of the eyelids and conjunctiva;
• corneal erosion;
• lagophthalmos (incomplete closure of the eyelids).

Classification

By the nature of the origin of keratitis are distinguished:

• exogenous;
• endogenous;
• keratitis of unknown etiology.

According to clinical manifestations:

• catarrhal;
• purulent;
• non-purulent.

By localization:

• Superficial, when part of the cornea, epithelium or anterior plate (Bowman's membrane) is involved in inflammation.
• Deep (stromal) involving the entire corneal stroma, posterior membrane (Descemet's membrane) or internal endothelium.

By the nature of the flow:

• spicy;
• subacute;
• chronic.

Symptoms

Symptoms depend on the nature of the lesion, the course and cause of the disease.

For keratitis of any etiology is characteristic common feature, so-called corneal syndrome, which includes three main symptoms:

• Photophobia (photophobia) - in bright light, the patient feels pain, inability to open his eyes, blinks often and squints his eyes.
• Lacrimation is an excess secretion of tear fluid.
• Blepharospasm - reflex contraction of the circular muscles, closing of the eyes.

Symptoms of keratitis can be varying degrees severity and are due to the severity of the condition. Many types of diseases are characterized specific symptoms, but there are also many common ones:

• corneal syndrome;
• sense of presence foreign body, as if the eyes were "covered with sand";
• the appearance of an infiltrate;
• clouding of the cornea and the associated decrease in visual acuity;
• redness of the eyes, pronounced vascular network (pericorneal or mixed injection);
• pain in the eyes;
• the appearance of serous or mucopurulent discharge;
• inflammation of the conjunctiva;
• headache.

Quite often, keratitis is accompanied by inflammation of the sclera, conjunctiva, and iris. The disease can affect all parts and membranes of the eye.

The resulting infiltrates are different in shape, depth of placement and size. Infiltrates at severe course diseases often turn into ulcers, which can spread to nearby membranes, up to perforation.

Superficial infiltrates can completely resolve without leaving any trace.

With various types of keratitis, a very characteristic picture takes place.

With neurogenic keratitis, as a result of damage to the trigeminal nerve, sensitivity disappears and there are no pronounced symptoms. Later, swelling and inflammation appear.

With keratitis caused by Pseudomonas aeruginosa, the course of the disease is especially severe. During the formation of an abscess, the patient suffers from severe pain in the eye, the inner membranes are affected. In this case, a complication in the form of atrophy of the eyeball is possible.

Diagnostics

Diagnosis of keratitis includes examination of the patient by a doctor and hardware examinations.

Basic diagnostic methods:

• Collection of anamnesis. It is necessary to find out what preceded the disease, whether there were injuries or other injuries, whether there are infectious or viral diseases.
• Patient examination. During the examination, the nature of the damage, its extent and characteristic symptoms of the disease are clarified. This allows you to make a more accurate diagnosis and establish the cause of the disease. Research methods:
  • Visometry. Checking visual acuity using an ophthalmic table.
  • Fluorescein test. This test reveals a violation of the integrity of the corneal layer.
  • Analgesimetry. This is a pain test.
• Ophthalmoscopy. This is an examination of the eye and the fundus itself. Examine the retina choroids and optic nerve. The examination is carried out using a special instrument - an ophthalmoscope.
• Biomicroscopy. This is a hardware method for diagnosing eye diseases. For it is used optical device – slit lamp, which allows you to explore the optical environment of the eye and detect any microscopic changes.
• Microscopy. This is a scraping study that allows you to find out which pathogens caused keratitis.

If there is a suspicion that an internal infection of the body has become the cause of keratitis, then the necessary examinations are prescribed for the presence of infections (, etc.).

Treatment

After a thorough examination, the doctor determines the treatment regimen. In case of minor lesions and inflammations, the patient can be treated on an outpatient basis.

With more serious injuries, acute inflammation, purulent discharge, the patient is sent to the hospital.

Necessary activities:

• To relieve pain, an anesthetic is prescribed.
• If the cause of keratitis was wearing contact lenses(in this case, scratches and microcracks occur), special eye gels are prescribed that restore the integrity of the cornea. For the duration of treatment, it is recommended to limit the use of lenses.
• If keratitis is caused by the ingress of a foreign body, then it must be without fail extract, and further therapy depends on the nature of the damage to the eye. Significant injuries may require surgery.
• In case of violations of the work of the eye glands, apply drops that moisturize the eye.
• In allergic keratitis, antihistamines are prescribed, but eye drops alone may not be enough, and the patient is prescribed hormonal or antihistamine drugs in the form of tablets or injections. In this case, the most important thing is to eliminate the effect of the allergen.
• Used for bacterial infections antibacterial drugs. The widespread use of embedding antibacterial ointments, in severe cases prescribe parabulbar or subconjunctival injections of drugs. If this is ineffective, then the antibiotic may be prescribed orally, intramuscularly, or even intravenously.
• Used for viral keratitis antiviral drops. The doctor prescribes the treatment regimen; at the beginning of treatment, the drug is often dripped, gradually reducing the number of instillations to three times a day.
• With syphilitic eye damage, joint treatment with a venereologist is carried out. Appointed large doses antibiotics not only in the form of eye drops, but also intramuscularly.
• With tuberculous keratitis, the ophthalmologist conducts treatment together with a phthisiatrician. Treatment is long and difficult.

In some cases, in addition to drug treatment, use laser coagulation, diathermocoagulation and cryotherapy. These methods allow you to act pointwise on the affected areas.

They also prescribe a course of vitamins and a special diet.

It should be noted that self-medication is not worth it, otherwise it can lead to the transition of the disease to chronic form, complications, a significant decrease in visual acuity, up to blindness.

The necessary treatment is carried out in a complex, this allows you to achieve good result and prevent complications. In the absence of positive dynamics in complex treatment, a sharp decrease in visual acuity or chronic inflammation of the cornea of ​​the eye, its transplantation is possible.

From quality medical measures and the nature of the lesion depends on the duration of therapy and the speed of recovery of the patient.

Complications

After the treatment of keratitis, a number of complications may remain:

• foci of turbidity that reduce visual acuity (scars are formed, the so-called thorn);
• development of secondary glaucoma;
• (purulent formations of the vitreous body);
• perforation of the cornea;
• irreversible permanent decrease in vision;
• atrophy optic nerve;
• septic complications.

Prevention

Prevention of keratitis is quite simple and includes:

• Compliance with personal hygiene, especially by persons who wear contact lenses.
• Timely treatment other eye inflammations (conjunctivitis, etc.).
• Timely seeking professional help from an ophthalmologist, visiting him at least once a year.
• Protection against chemical attack, dust, ingress of foreign bodies, bright UV radiation.

Forecast

In modern ophthalmology, keratitis is perfectly treatable without any complications. In severe cases, corneal opacities may remain, and as a result, reduced vision.

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Inflammation of the cornea of ​​the eye is called keratitis. It occurs as a result of a person's injury, development infectious process or exacerbation of an allergic reaction. Keratitis manifests itself in the form of clouding or a sharp decrease in vision in a person.

The main causes of the development of keratitis

Doctors note that the disease can be formed as a result of the following factors:

• the development of an infectious process in the patient's body;
• due to prolonged wearing of contact lenses;
• the patient receives a corneal injury;
• exacerbation of an allergic reaction;
• the development of photokeratitis, characteristic of people working with welding;
• with hypo- and beriberi;
• with violations of innervation, which occurs as a result of damage to 1 branch of the trigeminal nerve.

Symptoms of keratitis

Keratitis can begin in such manifestations as the development of corneal syndrome. It is characterized by an increased flow of tear fluid from the eyes, the development of a fear of light, the formation of blepharospasms. Additional Features keratitis:

• The appearance of pain in the eye and the presence of a foreign body in it: the patient is not able to open the eye on his own. These symptoms develop on the basis of the innervation of the cornea of ​​​​the eye.
• Development of pericorneal or mixed infection. A pericorneal infection usually affects the tissues near the cornea of ​​the eye.
• Pus, hypopyons and precipitates located in the back of the eye. Precipitates usually consist of lymphocytes, macrophages, plasma cells, pigment dust, which is located in the chamber moisture.
• Decreased vision and the formation of opacities in the eye.

Types of keratitis

According to the form, the disease is divided into the following types:

• acute;
• chronic. This form is characterized by the formation of abscesses, necrosis, ulcerations, lesions in the cornea of ​​the eye.

Also, doctors keratitis is divided into the following types:

• According to the depth of damage: superficial and deep. In superficial keratitis, only the upper stromal layers of the skin are damaged. With the development of deep keratitis, damage extends to all stromal tissues.
• According to the zone of damage localization: central, paracentral, peripheral. Central keratitis is localized in the pupil of the eye. Thus, the larger the area of ​​damage to the pupil of the eye, the worse eyesight in a person. Paracentral keratitis is usually localized in the iris. Peripheral keratitis is localized in the limbus, the ciliary zone of the iris.
• According to etiological signs, keratitis is divided into: exogenous, endogenous, allergic, neurogenic, infectious, herpetic, bacterial, fungal, avitaminous, viral and hypovitaminous. It is noteworthy that exogenous keratitis is characterized by corneal erosion, traumatic, bacterial, viral, fungal lesions of the eye cells, as well as damage to the eyelids, meibomian glands and conjunctiva of the eye. Endogenous keratitis develops as a result of the appearance in humans of such diseases as tuberculosis, malaria, syphilis, brucellosis.
• Also, according to the degree of damage to the eye, keratitis is divided into such types as meibomian, filamentous and rosacea.

It is important to note that keratitis usually appears as a result of the development of keratoconjunctivitis, keratoscleritis, keratouveitis, iridocyclitis, iritis. If a person has a purulent inflammation of the three membranes of the eye, then this can lead to premature death.

The main symptoms of keratitis

Doctors note that the development of keratitis in a patient is characterized by the appearance of the following symptoms:

• presence pain in the eye area;
• increased secretion of tear fluid;
• the appearance of a sensation of the presence of a foreign body in the eye;
• having problems opening the eye;
• the appearance of redness in the eyeball.

It is important to remember that the appearance of one of the above signs indicates that a person needs to visit a doctor. The patient should not independently diagnose and engage in independent treatment of the disease.

Diagnosis of keratitis

For staging accurate diagnosis the following diagnostic methods are used:

• examination of the patient;
• performing a visual acuity test;
• implementation of eversion of the eyelids by a doctor. This is necessary to exclude the presence of a foreign object in them;
• performing biomicroscopy. This method is based on the study of the eyeballs with a microscope;
• cornea staining with fluorescein. The substance helps to improve the visual picture of the degree of damage to the cornea of ​​\u200b\u200bthe eye;
• performing analgesia. This method helps to study pain sensitivity person.

Additionally, the patient may be assigned to undergo eye microscopy and bacterial culture from the cornea of ​​the eye. These methods are necessary to detect sensitivity to the presence of hepatitis virus antibodies in a patient. He will also need to donate blood for RW analysis and rheumatic tests. In addition, he is prescribed fluorography and the delivery of intradermal allergic tests.

Also, the patient must undergo an examination of the lacrimal ducts and sanitize them before treatment. It is important to remember that this procedure prescribed for severe stages of the development of the disease. In order to exclude the presence of foci of focal infection, the patient should visit an otolaryngologist and a dentist. If the disease appeared as a result of the presence endogenous causes, then a person should visit a therapist, rheumatologist, gynecologist, urologist, allergist, venereologist and phthisiatrician.

It is important for all patients to remember that only an experienced specialist can answer the question: “How to treat keratitis?”, and you should not try to get rid of this disease on your own. This can lead to an exacerbation of the disease and an increase in symptoms, as well as a deterioration in overall health.

How is keratitis treated?

Treatment of keratitis includes general and local procedures. Usually, keratitis can be cured in a hospital. In some cases, doctors allow the patient to be treated on an outpatient basis, but this is carried out under the supervision of the attending physician and with the obligatory observance of all his recommendations.

Outpatient treatment is possible if the disease is superficial.

The usual treatment for keratitis in adults includes following methods:

• Use of detoxification therapy. It includes the introduction of a drug such as Rheosorbilact 200.0 mg intravenously.
• For internal use, antibiotic, antiviral and antifungals. They are selected depending on the type and sensitivity of the pathogen.
• Purpose of desensitizing therapy. It involves the administration of 10% sodium gluconate through a drip.
• Also, the patient is prescribed the use of multivitamins, 1 tablet from 1 to 2 times a day.
• Carrying out treatment with folk remedies includes: instillation of disinfectants and antibacterial drugs.
• To disinfectants should include 20% sodium sulfacyl, miramistin.
• Antibacterial drugs include Floxal, Tobrex and Oftakviks.
• All drugs, when the initial signs of the disease appear, are instilled every two hours, and after that every 4 hours. In the event that there is no damage to the epithelium, then the patient can use hormonal preparations. These include Oftan-Dexamethasone and Maxidex. They should be instilled 2 times a day.
• During development, drops such as Okoferon and Oftan-ilu are used. Okoferon should be instilled at least 5 times a day. Oftanid should be used every hour, and then reduce the dosage to 3 times a day.
• Anti-inflammatory drugs used for keratitis include Naklof and Indocollir. They should be used within 4 to 6 hours.
• Mydriatic agents, which are also used in this disease, include tropicamide, mezaton, atropine. They contribute to the expansion of the pupil of the eye and reduce the likelihood of adhesions in it.
• To speed up the process of epithelialization of the cornea of ​​​​the eye, a remedy such as Korneregel is used. It should be used 2 to 3 times a day.
• With development, Zovirax ointment and Acyclovir tablets are used. Last drug should be taken orally at 200 mg and this should be done at least 5 times a day. Course reception is from 7 to 10 days.
• In case of infection of the lacrimal ducts, they should be washed every day with a 0.25% solution of chloramphenicol. You can also use a 0.01% Miramistin solution or a 1:5000 diluted solution of furacilin.

• If the innervation is disturbed during the development of keratitis, then the patient should use erythromycin, 1% tetracycline ointment or Floxal ointment. All means eliminate the causes of neuroparalytic inflammation of the cornea of ​​​​the eye.
• In order to speed up the process of epithelialization and resorption of scars on the eye, physiotherapeutic methods such as electrophoresis and magnetotherapy are used.
• If herpetic keratitis does not go away for a long time, then cryotherapy, laser coagulation, diathermocoagulation of problem areas of the skin are used.

Also, all patients during treatment are advised to adhere to special diet which includes eating foods with great content protein, vitamins and minerals. You should also reduce your intake of foods high in fat and carbohydrates.

Thus, keratitis is an unpleasant disease that you can quickly and without harm to your body get rid of. To do this, you must pass comprehensive examination and when the first unpleasant symptoms in the eye area, see a doctor immediately.

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Keratitis is a group of inflammatory lesions of the cornea, the anterior transparent membrane of the eye, of various etiologies, causing clouding of the cornea and decreased vision. Often the process is accompanied by redness of the eyeball due to the expansion of the vascular network of the perilimbal region. In cases where the patient turns to the doctor late, it may develop festering ulcer cornea, the outcome of which will be the death of the eye as an organ. Another outcome may be the formation of a corneal leukoma, which will lead to poor visual acuity.

Keratitis: what is it?

Keratitis is an inflammation of the cornea of ​​the eye that occurs as a result of injury, infection or allergy, manifested by its clouding and decreased visual acuity. Keratitis is localized in the anterior part of the eye, or rather in its cornea. It is often the result of previous inflammation of the eyes (conjunctivitis, and others).

The basis of inflammatory opacification is an infiltrate - an accumulation in the corneal tissue of cellular elements of the type, lymphocytes, histiocytes, plasma and other cells that came here mainly from the marginal looped network. If the disease is complicated by a purulent infection, then with the development of an infiltrate, necrosis of the corneal tissue occurs and ulcerations appear. After the ulcer has healed, scar tissue, and subsequently manifested leukoma.

Allocate:

Depth of injury:

• Superficial - the upper stromal layer is affected;
• Deep - the entire stromal layer is affected.

According to the location of the infiltrate:

• Central - in the pupil area. The more central the infiltrate is located, the more vision suffers both during the period of illness and after treatment;
• Paracentral - in the projection of the iris;
• Peripheral - in the limbus zone, in the ciliary zone of the iris.

By etiology:

• Exogenous - corneal erosion, traumatic, bacterial, viral, fungal infection, damage to the eyelids, meibomian glands and conjunctiva;
• Endogenous - defeat by tuberculosis, malaria, syphilis,;
• Allergic;
• neurogenic;
• Infectious;
• herpetic;
• Bacterial;
• Fungal;
• Avitaminous;
• Viral;
• Hypovitaminosis.

Each of the forms of keratitis has its own characteristics, the manifestation of which depends on the general condition of the patient, his age and the nature of the pathogen.

The reasons

The largest number of cases of keratitis is associated with viral etiology. In 70% of observations, the causative agents are herpes simplex and herpes zoster viruses (herpes zoster).

Exogenous (outside action) causes include:

• mechanical damage;
• chemical impact;
• thermal impact;
• infections (tuberculous, syphilitic keratitis);
• fungal infections;
• bacteria (staphylococci, Pseudomonas aeruginosa);
• contact lenses;
• photokeratitis (found in professional welders).

Endogenous (action from the inside) include diseases of the cornea that have arisen due to:

• Strong infection(from inside);
• Triggering a reaction to neuroparalytic effects;
• Lack of important vitamins in the body.

In modern ophthalmology, keratitis is perfectly treatable without any complications. In severe cases, corneal opacities may remain, and as a result, reduced vision.

Symptoms of keratitis (eye photo)

Keratitis of any etiology is characterized by a common symptom, the so-called. corneal syndrome, which includes three main symptoms:

• Photophobia (photophobia) - in bright light, the patient feels pain, inability to open his eyes, blinks often and squints his eyes.
• Lacrimation is an excess secretion of tear fluid.
• Blepharospasm - reflex contraction of the circular muscles, closing of the eyes.

All this is due to the fact that with keratitis, as a result of the resulting infiltrate, irritation of sensitive nerve endings of the cornea, and also its transparency and luster decrease, the cornea becomes cloudy and loses its sphericity.

In the early stages, one of the first symptoms is a sensation of a foreign body in the eye, increased corneal vascularization. Some patients have blepharospasm. Pathological closure of the eyelids contributes to increased stimulation of the trigeminal nerve due to irritation of peripheral receptors. Inflammation of the nerve sheaths leads to " facial clinic". An external examination visualizes the asymmetry of the corners of the mouth, twitching of individual muscles, difficulty in speech.

The most significant symptom of keratitis is a violation of the transparency of the cornea. This phenomenon is a direct consequence of the appearance of infiltration and edema of cellular elements. There are noticeable changes in the state of the epithelium of the cornea: its luster disappears, and roughness occurs. In some cases, detachment and desquamation of the epithelium occurs. As a result, erosion appears on the surface.

Depending on how deep into the tissue it has spread pathological process, infiltrates can be superficial or deep.

1. Superficial infiltrates often resolve on their own without any treatment and leave a slight haze behind.
2. At the same time, deep infiltrates often disappear only after long-term treatment with “heavy” drugs and often leave behind cicatricial changes that negatively affect visual functions person.

Eye keratitis in children

Sometimes parents are worried whether keratitis is contagious or not, since there may be more children in the family, and whether they need to be isolated from a sick baby. Yes, it is transmitted by contact. Many of the symptoms of keratitis are similar to those of allergic conjunctivitis. Even doctors require multi-stage and thorough diagnostics to separate these two diseases.

The first signs of the disease will be:

• pain in the eyes; fear of light;
• profuse lacrimation;
• blurred vision;
• involuntary contraction of the circular muscle of the eye, which leads to pathological closing of the eyelids;
• itching and burning in the eye.

Treatment of a child with keratitis begins with washing the lacrimal ducts, taking a smear to determine the causative agent of the disease and its sensitivity to antibiotics. Carry out local and general therapy. Local therapy is based on such methods as installations and subconjunctival injections. General therapy consists in intravenous, oral and intramuscular administration of drugs.

Possible Complications

Like any untimely cured disease, keratitis can lead to complications. This is possible when the inflammation passes from the cornea of ​​​​the eye to its other membranes. This may lead to such unpleasant illnesses, how:

• decreased quality of vision due to clouding of the cornea, the formation of a walleye and adhesions in the pupil area;
• endophthalmitis (suppuration of the inner membranes of the eyeball);
• secondary;
• panophthalmitis (inflammation of the tissues of the eyeball with the formation of abscesses);
• phlegmon of the orbit;
• irritation of the anterior vascular eye membranes;
• herpetic keratoiridocyclitis;
• perforation of the cornea;
• thrombosis of the cavernous sinus;
• iridocyclitis.

Diagnostics

In the diagnosis of keratitis, its connection with previous general diseases, viral and bacterial infections, inflammation of other structures of the eye, microtrauma of the eye, etc. is important. During an external examination of the eye, the ophthalmologist focuses on the severity of the corneal syndrome and local changes.

The doctor conducts the following diagnostic methods:

• external examination,
• visual acuity test,
• eversion of the eyelids is required to exclude a foreign body,
• biomicroscopy (examination of the environment of the eye with a microscope),
• corneal staining with fluorescein (for better visualization of the degree of damage to the cornea),
• analgesimetry (determination of pain sensitivity).

Eye keratitis treatment

Treatment should be carried out under the supervision of an ophthalmologist in a specialized hospital for 2-4 weeks. The general principles of pharmacotherapy of keratitis include local and systemic etiotropic therapy with the use of antibacterial, antiviral, antifungal and other drugs.

General treatment for all keratitis:

• detoxification therapy (rheosorbilact 200.0 intravenous drip),
• oral or parenteral antibiotics, antiviral and antifungal drugs depending on the type and sensitivity,
• desensitizing therapy (calcium gluconate 10% is added to the dropper),
• In parallel, the patient must take a course of admission vitamin complex. It is especially important in this case appointment of vitamins B1 B2, B6, C, PP. Assign multivitamins 1 tablet 1-2 times a day.

An important role is played by the use of drugs that dilate the pupil to prevent the formation of adhesions inside the eye. According to indications, glucocorticosteroid drugs are prescribed - dexamethasone or betamethasone.

Groups of drugs that are used:

1. antibacterial agents. They are prescribed for a purulent type of inflammation. With keratitis, drops of Levomycetin, Tobrex, Floksal, Tsipromed are used. severe forms diseases may require the introduction of antibiotics under the conjunctiva or into the muscle;
2. antiviral drugs: iduxoridin solution, Zovirax, Zirgan, Interferon, Florenal,. Used for herpetic and adenovirus inflammation;
3. local anesthetics "Diftal". Help relieve corneal syndrome, provide eye pain relief;
4. mydriatics (Atropine, Cyclomed, Tropicamide). These are drugs that dilate the pupil. They are necessary with concomitant iridocyclitis to prevent adhesions between the pupil and the iris;
5. corticosteroid drugs (Dexamethasone, Hydrocortisone) are used to reduce inflammation and swelling;
6. healing agents (Korneregel, Actovegin). Promotes regenerative processes after injuries and erosions;

Additionally, keratoprotective, epithelializing medicines. In severe cases, antibiotic injections are performed under the mucous membrane of the eye.

Eye keratitis is treated exclusively under the supervision of an ophthalmologist in conditions specialized hospital within a few weeks. Wherein general approach to treatment includes the elimination of local and systemic causes, as well as the use of antibacterial, antiviral, and other drugs.

Prevention

Don't forget that the best treatment is prevention. Therefore, in the case of keratitis, it is very important to avoid traumatic eye injuries, especially if professional activity associated with such risks. Secondly, it is important not to start even simple, at first glance, eye diseases.

• take care of hygiene
• properly care for contact lenses, if any,
• protect eyes from influence harmful effects and ingress of foreign bodies,
• treat any emerging eye diseases,
• try to prevent diseases that can provoke keratitis;
• diet with large quantity proteins, trace elements, vitamins and limiting the amount of fats and carbohydrates.

To prevent the manifestation of this disease, it is important to prevent eye injuries, treat conjunctivitis, blepharitis, dacryocystitis in time, as well as common diseases that predispose to the development of keratitis.

It is especially important to engage in prevention for those who have already been ill with this disease, because this reduces the risk of developing a recurrence of keratitis.

Vision is our main connection with the outside world. Any violation immediately becomes a serious problem. But are people so attentive to ophthalmic diseases? AT last years more and more often the diagnosis chronic keratitis". What's this?

The most important optical structure of the eye is the cornea. Being actively exposed to heat, light, foreign bodies and different kind microorganisms, the cornea is not protected from functional and anatomical disorders (inflammatory processes, tumors, injuries).

Inflammation of the cornea, which is accompanied by its clouding, is called keratitis. The disease has different ways origin, the main sign of keratitis is the presence inflammatory infiltrates(seals), which are located in different parts of the cornea, have diverse shapes and depths.

To date, incorrect diagnosis and untimely treatment of keratitis are the cause significant reduction eyesight a large number patients.

Varieties of keratitis

bacterial(staphylococcal, malarial, tuberculosis, syphilitic, etc.);
viral(measles, smallpox, adenovirus, herpetic);
infectious-allergic(allergic and phlyctenular);
exchange(protein and vitamin deficiency);
other keratitis (post-traumatic, fungal, neuroparalytic, etc.).

In recent years, mixed forms of keratitis have become increasingly common. This complicates both the diagnosis and treatment of the disease. As a rule, recovery in such cases is more difficult than usual, relapse is possible. Often the herpes virus has a dominant role in mixed forms of inflammation of the cornea of ​​​​the eye.

Symptoms and signs of keratitis

Pain in the eyeball;
previously unmanifested photophobia;
causeless lacrimation;
corneal irritation;
blepharospasms.

Another important sign of inflammation is clouding of the cornea. The cause is edema and an excessive amount of cellular elements coming from the marginal looped vascular network.

This can be expressed in violations of such characteristics of the cornea as:

Transparency;
sphericity;
shine;
specularity;
sensitivity.

This is due to the fact that the infiltration of the cornea entails changes in its layers. In advanced forms of keratitis, the development of ulcers, the appearance of an abscess, and in the most severe cases, necrosis or a purulent infiltration process with subsequent disintegration of the corneal epithelium is possible. With a non-purulent development of the disease, the corneal cells grow and, in the future, disintegrate.

In addition to infiltration, keratitis may be accompanied by ingrowth of newly formed vessels into the stratum corneum of the marginal looped network of vessels. Also, there is often an increase in blood vessels on the surface of the eyeball itself, which is an obvious and noticeable symptom. Superficial keratitis most often leads to the destruction and exfoliation of the epithelium. It is as a result of this that the brilliance and specularity of the cornea are disturbed.

Brief interesting data for inserting into the article:
* Keratitis in preschool children, which has constant recurrences in autumn and spring, is, as a rule, tuberculosis-allergic in nature.
* Animals also have keratitis. In dogs, the disease is typical mainly for shepherd dogs, Siberian Huskies and Border Collies, and keratitis is also often found in cats.
* The cornea can be stored up to several years with the help of conservation. Cases of transplantation of the cornea from deceased people are known.

An important factor influencing the course of the disease is general state patient and his work immune system. Also, its causes play an important role in the outcome of the disease and the restoration of all functions of the cornea.

As a rule, small superficial consolidations resolve without a trace. The consequences of infiltration located in the surface layers, under the shell, leave a small scar. Stroma infiltration, if the middle or deep layers are affected, does not disintegrate and leaves a fairly noticeable scar in the form of turbidity. Purulent forms diseases are associated with necrosis of cells, most often they decay and ulcerate.

Possible Complications

Causes of the disease

Diagnosis of keratitis

So, herpetic keratitis in most cases occurs after respiratory infections, influenza, pneumonia, pneumonia or sore throats. Purulent keratitis is more often caused by damage to the eyeball. Filamentous keratitis often develops against the background of the so-called dry eye syndrome and is chronic inflammation.

The acute period of keratitis in the vast majority of cases is accompanied by symptoms such as constant pain in the eye area, causeless lacrimation, previously unusual photophobia, blepharospasm and a feeling of having a small foreign body in the eye. This allows you to put provisional diagnosis: keratitis.

Often, children also have complaints of severe interfering pain in the eye, which indicates complications in the form of iridocyclitis. Tuberculous-allergic keratitis is accompanied by puffiness of the face, thickening of the wings of the nose, swelling of the lips, cracks in the corners of the eyes. If you look at the clinical picture as a whole, then the initial symptoms of all types of keratitis are similar, and the types and subspecies already determine the very course of the disease.

Tree-like keratitis has a pronounced symptomatology in the form of herpetic vesicles that merge with each other and resemble tree branches. This signals that the disease is spreading along the nerve branches. In half of the cases, dendritic keratitis causes complications and leaves a cloudy cornea, which means a significant decrease in vision. The sooner the diagnosis is made and treatment is prescribed, the easier the consequences of the disease will be.

Syphilitic (parenchymal) keratitis is often congenital disease. With this type of keratitis, inflammation occurs in the stroma, that is, in the posterior layers of the cornea. Often the disease affects children from five years of age.

There are three stages: progressive, vascular and regressive. The first is accompanied by a gradual and slow development of the symptoms of the disease, often after a month, patients are diagnosed with iridocyclitis. With a sufficient level of infiltration, vascular germination begins, and vascularization occurs. The period of vascularization lasts up to 7-8 weeks. A lot of blood vessels can be affected, causing the cornea to turn dark red. At the regressive stage, turbidity resolves, other symptoms decrease. The process is very slow, sometimes dragging on for a year or more.

As a rule, both eyes are exposed to syphilitic keratitis at once. This is its distinguishing feature, which greatly simplifies the diagnosis. High chance of relapse. Vision is restored in 70% of cases, but opacities may remain on the cornea.

Treatment of keratitis

To reduce inflammation and pain, the patient is prescribed mydriatic agents. These are either drops similar drug in the form of a medicinal eye film, a variety of ointments. All of these drugs are based on atropine in different concentration. A course of electrophoresis procedures with atropine is also effective.

Ulcerative keratitis necessarily involves treatment with antibiotics and sulfonamides. In case of education severe ulcers, the antibiotic can be administered directly under the conjunctiva.

As soon as the inflammatory process is stopped, the doctor prescribes osmotherapy and resolving procedures. The patient again undergoes a course of electrophoresis, but with a solution of potassium iodide. It is also possible to use biogenic stimulants like aloe extract.

In difficult cases use surgical treatment. It can be antiglaucomatous surgery, keratoplasty. Surgical intervention - last resort, but sometimes only this allows you to save vision.

Folk remedies do not give effect in the treatment of keratitis. Eye diseases are a serious danger of reducing and even losing vision, so the risk is inappropriate here. At the first symptoms of keratitis or other inflammatory eye disease, you should immediately contact a specialist and in no case engage in self-treatment.

Prevention of keratitis

Acanthamoeba keratitis is an inflammation of the cornea that can occur in people who constantly wear contact lenses. This type of keratitis is difficult to treat, most often requires surgical intervention, so it is easier to carry out a series of simple preventive actions than to treat it. To prevent the development of the disease, it is necessary to strictly follow the instructions for using the lenses, as well as properly care for them.

Keratitis is not a sentence. In at least half of the cases, it is possible to maintain vision at the same level. The most important thing is to start treatment on time and bring it to the end. It is important not only to remove inflammation, but also to conduct a course of resolving procedures that help get rid of corneal opacities and restore all its functions.

Keratitis is an ophthalmic disease in which the patient has an inflammatory lesion of the cornea of ​​​​the eye, which is accompanied by its ulceration, clouding, pain syndrome and hyperemia.

Keratitis

Eye keratitis is a fairly common disease, so when making this diagnosis, patients usually do not ask what it is. In the absence of treatment of this pathology, patients may experience a decrease in visual function.

Today, physicians distinguish the following reasons keratitis:

• any injury to the cornea that adversely affected its integrity;
• viral damage to the cornea of ​​​​the eye (as a rule, the causative agent of herpes in this case is herpes);
• bacterial or fungal infection of the eye;
• complications after untreated conjunctivitis;
• violation or complete impossibility of closing the eyelids as a result of any injuries, disruption of the activity of the facial nerves;
• allergic reactions;
• deficiency of vitamins, especially vitamin A;
• negative impact on the cornea of ​​contact lenses.

Types of keratitis

Ophthalmologists distinguish the following types of keratitis: deep and superficial.

In the first case, the disease is usually a complication of conjunctivitis or other inflammatory eye diseases. After superficial keratitis, the patient does not have scar tissue measurements, and the cornea does not darken.

At the same time, deep keratitis of the eye is characterized by damage to the deeper layers of the eyeball. After therapy for deep keratitis, many patients experience scarring of the cornea of ​​the eye, which further negatively affects vision.

That is why, when the first symptoms of this pathology occur, it is recommended not to hesitate and not to engage in self-diagnosis and self-treatment, but to contact a specialist. Only the doctor knows correct symptoms and treatment of keratitis.

In order to avoid serious complications keratitis, specialists often prescribe hormonal drops and other “heavy” medications to patients.

Varieties of pathology

As a rule, this form of the disease develops after an eye injury or with prolonged wearing of contact lenses, with poor hygiene when wearing lenses. Pseudomonas aeruginosa usually causes bacterial keratitis. Although in some cases other bacteria can be the causative agents of the disease. Acanthamoeba keratitis is one of the most complex forms of bacterial keratitis. In this case, the disease often affects both eyes at once and often leads to complete blindness.

Viral keratitis

In 80% of cases, the causative agent of viral keratitis is the herpes simplex virus;

Onchocercal keratitis

The cause of this pathology is usually various allergic reactions that occur in severe form. In this case, the pathology can affect both the anterior and back department eyeball. In the absence of timely treatment, pathology often leads to sclerosis of the eye membranes. The first signs of this pathology are itching, increased lacrimation and photophobia. At the same time, patients often complain of corneal redness and severe swelling century. With absence medical care illness can lead to a strong decline vision and, in some cases, total blindness.

As a rule, this form of the disease develops in patients who have previously received an injury to the cornea of ​​​​the eye. foreign objects. Ulcerative keratitis is often combined with purulent inflammation of the lacrimal sac. The disease is very difficult and, if left untreated, can result in perforation of the cornea.

In this form of the disease, the causative agent is usually various kinds pathogenic fungi. In this case, the patient experiences severe pain, the cornea of ​​\u200b\u200bthe eye begins to turn red. With fungal keratitis, the patient develops ulcerations in all layers of the cornea (both superficial and deepest). In advanced cases, a through hole may form in the eyeball in patients. In this case, the inflammatory lesion affects not only the cornea of ​​​​the eye, but also nearby vessels (vascular keratitis). Often fungal infection leads to the formation of a thorn and deterioration of vision. Fungal keratitis is very difficult to diagnose. That is why the treatment of this disease often begins at the wrong time and goes wrong.

As a rule, this pathology occurs in patients in the spring season, when flowering begins. various plants. The main cause of the disease in this case is an allergy.

Non-ulcerative keratitis

This is a fairly mild form of the disease, in which the cornea swells, but ulcerative lesions do not form on it. Often develops due to ingestion pathogenic bacteria on the cornea of ​​the eye;

Photokeratitis

This form of keratitis usually develops as a result of getting burned from ultraviolet rays or artificial bright lights. Often, patients with this pathology turn to doctors after a long exposure to the sun without sunglasses or after using welding machines and neglecting protective parts.

Herpetic keratitis

The causative agent of this pathology, as a rule, is herpes simplex, much less often - the herpes zoster virus. After this form of the disease, patients often have deep ulcers on the corneas of the eyes. It is a form of keratitis prone to relapse. It can be both superficial and deep. At surface form pathologies on the cornea of ​​the eye are formed cloudy spots. Superficial herpetic keratitis almost always proceeds without bright severe symptoms. However, this kind of disease is extremely rare. Much more often, patients turn to doctors with deep herpetic keratitis of the eye. With it, the patient develops extensive ulcerative lesions on the surface of the cornea. When such patients recover, cicatricial changes occur in the tissues of the eye, and a thorn often forms.

Prognosis and prevention of the disease

If the patient noticed signs of keratitis in time and immediately consulted a doctor, then the prognosis of the disease will be quite favorable. Physicians, if available huge amount medications today it will not be difficult to stop the pathological process in the cornea of ​​the eye. This means that the loss of vision and the formation of a walleye can be completely prevented.

Prevention of the disease includes measures by which a person can avoid the development of pathology. Such measures include proper storage and use of contact lenses. Lenses should be stored only in a special container. They can't be touched dirty hands or wear them longer than the prescribed period.

In addition, the prevention of corneal keratitis also lies in the timely treatment of conjunctivitis, since it is often a complication. It is also important to treat herpes in time, strengthen the immune system, use enough vitamins.

It is also worth avoiding injuries that can lead to the development of keratitis, and if they are received, immediately consult a doctor.

Symptoms of keratitis

Keratitis is almost always accompanied painful sensations, the severity and nature of which largely depend on the prevalence of the process, as well as the reasons that provoked it.

With this pathology, the human sclera turns red, and the surface of the cornea of ​​\u200b\u200bthe eye loses its healthy luster.

Often, keratitis is combined with corneal syndrome, the main symptoms of which are:

• photophobia;
• involuntary blinking or complete closure of the eyelids and the inability to open them;
• pathological tearing;
• sensation of a foreign body in the eye;
• decreased sensitivity of the cornea.

When examining such patients, ophthalmologists can see blood and lymph impurities (infiltrates) in the cornea, which are usually accompanied by clouding of the eye. These infiltrates different patients may have different sizes, shapes, colors and be present in different quantities.

Depending on how deep the pathological process has spread into the tissue, infiltrates can be superficial or deep.

Superficial infiltrates often resolve on their own without any treatment and leave a slight haze behind.

At the same time, deep infiltrates often disappear only after long-term treatment with “heavy” drugs and often leave behind cicatricial changes that negatively affect the visual functions of a person.

In order to determine how long the patient has an infiltrate, doctors examine its borders. So, blurry edges usually have fresh infiltrates, while clear ones have old ones that will soon begin to resolve.

Almost always, signs of keratitis include active vascularization of the cornea. In this process, the vessels begin to grow into the cornea of ​​​​the eye. This has an extremely negative effect on the resorption of infiltrates.

On the one hand, vascular ingrowth is a protective reaction of the cornea, and on the other hand, it has an extremely negative effect on its transparency, as it is normal for healthy person there are no vessels in the cornea of ​​the eye (which is why the cornea is transparent).

In severe cases, inflammation in keratitis can also spread to the iris and ciliary contour. If keratitis is not treated on time or attempted to be treated on its own, it can lead to corneal ulceration and even rupture.

In addition, a frivolous attitude to one's health in this case can result in infection of the cornea of ​​the eye, which can provoke a purulent-necrotic process, which in turn almost always leads to a complete loss of the eye.

In general, the symptoms of keratitis can vary quite a lot depending on the age of the patient, the state of his body (and immunity in particular), individual features pathogens, etc.

Viral keratitis

The causative agent of viral keratitis is often the herpes simplex virus. With it, the lesion of the cornea of ​​\u200b\u200bthe eye can be both deep and light, superficial.

The very first and characteristic symptom herpetic keratitis is the formation on the cornea of ​​the eye of a large number of small vesicles filled with liquid. These vesicles subsequently open up on their own and leave behind ulcerations, which often resemble tree branches in shape. At the same time, the more advanced form of keratitis the patient has, the deeper ulcerations on his cornea will be present. Often the symptoms of viral keratitis include the formation of a large number of deep infiltrates.

Filamentous keratitis

Filamentous keratitis in humans occurs as a result of various pathological processes in the body. The main symptom of filamentous keratitis is pathological dryness of the eye (in some cases, patients may even have no tears when crying), cutting pain, photophobia, a sensation of the presence of a foreign body in the eye, involuntary closing of the eyelids.

In this case, a filamentous viscous secret is usually formed in the eye. In advanced cases, patients may experience signs of hyperkeratosis. In severe cases, hyperkeratosis can cover the entire area of ​​the cornea. In this case, its clouding occurs, as a result of which the vision of patients deteriorates sharply.

If left untreated, patients may experience recurrent erosions and ulcers, which can eventually lead to the appearance of a through space in the eyeball.

Purulent-ulcerative keratitis

A purulent ulcer of the cornea of ​​the eye also has characteristic features of the course, the causative agents of which, as a rule, are different kinds cocci. Even the most insignificant trauma of the cornea of ​​the eye or an inflammatory lesion of the eyelids can lead to this pathology. At the very beginning of the disease, patients usually have a gray spot in the center of the eye or in the paracentral part of the eye, in place of which, after a short period of time, an acute ulcerative process develops. In this case, one of the edges of the ulcer is often slightly raised, which often leads to its infection and the occurrence of a purulent-necrotic process. It should be noted that this phenomenon proceeds extremely rapidly. So, already 3-5 days after the onset of ulcer formation, the pathological process can spread completely to the entire cornea. In this case, at the bottom of the eyeball, as a rule, there is an accumulation of a sufficiently large amount of pus.

If at these stages the disease is not treated, then a through hole may form in the eyeball, through which pus will subsequently come out on its own. As a rule, after this, the patient begins to recover, and rough scars or thorns begin to form on the cornea, which further negatively affects vision.

It should be noted that recovery in such patients does not always occur. In some cases, the purulent-necrotic process can spread to healthy tissues of the human body.

Neurogenic keratitis

The main cause of neurogenic keratitis is the defeat of the trigeminal nerve. As a result, a flat ulcer begins to form in the center of the eye. Wherein this process can take a lot of time and not be accompanied by any special sensations, since the cornea of ​​​​the eye often completely loses its sensitivity.

With this form of keratitis, the clouding of the cornea is insignificant, and the ulcers, which have a small area, heal quickly. However, if an infection joins the ulcerative lesion, then the pathology can be complicated by a purulent-necrotic process.

Acanthamoeba keratitis

Patients who prefer contact lenses to glasses are at risk of Acanthamoeba keratitis. The disease got its name due to the causative agent - Acanthamoeba bacteria. This form of the disease is difficult to treat. However, it often affects both eyes. After such keratitis, the cornea of ​​\u200b\u200bthe eye often becomes cloudy, which in the future can negatively affect vision.

At the first symptoms of keratitis, patients should immediately contact an ophthalmologist, and not self-medicate. This pathology treated only in stationary conditions under the close supervision of doctors, since this disease can threaten significant changes in the structure of eye tissues, which in the future can provoke a decrease in vision and even lead to complete blindness.

Treatment of keratitis

Keratitis is a serious inflammatory disease of the cornea of ​​the eye, manifested by a variety of ophthalmic symptoms. The treatment of this disease is carried out by an ophthalmologist in a specialized medical hospital. Treatment of keratitis is determined by three factors: the cause that caused the disease; the depth of corneal damage and the severity of the process.

The following types of therapy are used in the treatment:

• Medication methods of exposure, including antibacterial and antiviral agents, antiseptic solutions, drugs that promote epithelialization on the cornea, etc.
• Surgical methods: keratoplasty, corneal transplant, etc.

Medical therapy

Treatment of keratitis is recommended to be carried out in a medical hospital (due to the risk of developing severe complications for the patient's vision). The basis of the treatment of keratitis is the elimination of the causative factor. Most often, in adults, it is a bacterial or viral infection that affects the cornea both initially and against the background of an infectious disease of a different location in the body. In children, the most common cause of keratitis is a viral infection and eye trauma. It is very important to stop using lenses for the duration of the treatment of keratitis.

Treatment of viral keratitis requires an appointment antiviral agents, which, as a rule, are used in the form of drops or ointments that must be placed in the conjunctival sac. In addition, it is possible to use interferon preparations and interferon inducers both locally and as a systemic application. Interferons make it possible to block the reproduction of the virus and its transition from cell to cell, thereby reducing the intensity of the course of the disease and damage to the cornea. Additionally, immunomodulators are used orally or intravenously to stimulate the activity of the immune system.

If, against the background of antiviral therapy, ulcers form on the cornea, then it is necessary to use microsurgical methods (microdiathermo- and laser coagulation, cryoapplication), which allow closing the resulting defect and preventing its spread to healthy eye tissues.

Herpetic keratitis is treated with aciclovir, taken both orally in the form of tablets and topically, in the form of drops. This allows you to easily and quickly block the virus in the body and destroy it. Most modern drug acyclovir groups - ganciclovir ( tradename eye gel- zirgan). In no case should you use glucocorticosteroid ointments, since their use against the background of infectious keratitis can lead to the formation of extensive corneal ulcers and the spread of infection to other parts of the eyeball. If therapy is not effective within a month, then it is recommended surgery as a corneal transplant.

If keratitis is caused by a bacterial infection, then the key point of treatment is the appointment of antibacterial drugs. Most often, sulfonamides, penicillins and cephalosporins are used in the form of drops, ointments and special medicinal films. It is recommended to conduct a study on the sensitivity of the pathogen to antibiotics before prescribing these drugs. In severe purulent processes in the cornea (often when infected with staphylococcus and Pseudomonas aeruginosa), antibacterial drugs are administered subconjunctivally, as well as intramuscularly or intravenously. In cases of ulcer formation, microsurgery methods are indicated.

For specific types of keratitis, such as tuberculosis, drugs are used that are aimed at a specific pathogen - anti-tuberculosis drugs, anti-syphilitic, etc.

Along with medicines aimed at causal factor keratitis, other medications are also used:

Mydriatics, which improve the outflow of intraocular fluid from the eye cavity. Their use is due to the increased formation of intraocular fluid in keratitis due to the development of the inflammatory process in the cornea. They are usually used in the form of drops.

Antiseptic solutions allow you to quickly clean and disinfect the surface of the conjunctiva, clearing it of bacteria. Used in the form of drops for instillation or washing of the conjunctival sac.

Drugs that promote epithelialization of the surface of the cornea are especially often used against the background of formed and emerging ulcers. Allows you to quickly close the epithelial defect without formation connective tissue which helps maintain clear vision.

At allergic component disease is recommended to use eye drops with antihistamine properties (Opatanol) or containing glucocorticosteroids. It is especially important to eliminate the allergen that causes keratitis.

Vitamin therapy is also used to improve regenerative processes in the body and increase the rate of epithelialization of the cornea.

For the treatment of common herpetic ulcers, a corneoplast is used - this is a crushed dried and preserved cornea of ​​a person and a number of animals (pigs, sheep, etc.). In the root plast in large numbers contains collagen and keratin sulfate, which determine the main properties of the cornea. Corneoplast is distinguished by good therapeutic effect. With long-term, recurrent herpes keratitis, an anti-herpetic vaccine is used to cause a long-term remission of the disease in a patient.

With bullous keratitis, baths with a 10-20% glucose solution are used and 0.5% thiamine ointment is placed in the conjunctival sac. In addition, collazine is used in the form of eye drops or subconjunctivally with novocaine solution.

Surgery

Surgical treatments for keratitis are used in various forms of the disease. It is important to remember that during treatment and rehabilitation it is necessary to refuse to wear contact lenses for keratitis due to the risk of complications and progression of the disease. If ulcers form on the cornea, then microsurgical interventions are used: laser and microdiathermocoagulation or cryoapplication of the defect. These methods allow you to quickly stop the spread of the ulcer and improve the prognosis of a person in the long term.

If against the background of keratitis there was a clouding of the cornea and, as a result, a decrease in vision, then excimer laser scar removal techniques or keratoplasty are used. Select operation - layered keratoplasty to preserve the healthy layers of the cornea. Only corneal tissues changed as a result of the disease are subject to removal.

The development of secondary glaucoma against the background of keratitis requires laser or surgical correction given state, consisting in the normalization of the outflow of intraocular fluid from internal cavities eyeball.

If keratitis for a long time refractory to conservative treatment surgical methods, then in the best possible way treatment is enucleation of the eye.

Prevention of keratitis

The outcome and long-term consequences of the transferred keratitis depend on a number of factors: the cause of the disease, the depth and duration of the inflammatory process. Modern methods of treatment allow you to quickly cope with keratitis and prevent the development of opacities in the cornea.

Prevention of keratitis consists of several points: rapid detection and treatment of inflammatory diseases of the eye (conjunctivitis, blepharitis, dacryocystitis) and infectious diseases in the body. In addition, it is recommended to avoid traumatic effects on the eye, as well as undergo treatment for somatic and allergic diseases. Timely treatment of herpetic infections can minimize the risk of developing the most commonly detected herpetic keratitis.

In conclusion, one can answer the most frequently asked question, and whether it is possible to cure a keratitis? Yes, of course you can, with a timely visit to the doctor and the beginning of treatment. It is important to remember that keratitis is a disease that requires hospitalization of the patient due to the risk of complications from the eyeball and visual impairment. Diagnosis and treatment of keratitis should be carried out by an ophthalmologist.