Keratitis - Infectious Corneal Inflammation
Cause
The penetration of pathogens into the cornea can lead to an inflammation of the same. As microorganisms bacteria, fungi, viruses and parasites (especially acanthamoeba) are in the foreground. This can lead to protracted courses of therapy.
Symptoms
Contact lens wearers are particularly at risk for infectious keratitis. In the event of the occurrence of symptoms such as a reddening of the eye, a feeling of foreign bodies, pain, sensitivity to glare and a deterioration in visual acuity the ophthalmologist should be consulted at an early stage. This is because a diagnosis must be made as early as possible and appropriate therapy initiated.
Treatment
As a rule, the corneal inflammation heals with scarring under intensive eye drop therapy, if necessary also under systemic therapy. Depending on its location, the scar can also cause a reduction in visual acuity or a sensitivity to glare. In milder cases, therapy can be performed on an outpatient basis. In severe cases, inpatient treatment must be performed.
Infectious keratitis with scarring healing under therapy (Fig.1)
Corneal diseases
The cornea of the eye lies like a window in the front part of the eyeball. With its transparency and refractive power of about 43 diopters, together with the other refractive media of the eye, it ensures a good image of the environment on the retina. The sensory cells are also located on this.
It is composed of five layers (see diagram below) and has a thickness of about 530 um centrally and about 670 um peripherally (Fig.2+3). The sclera is adjacent to the conjunctiva, which is covered by the conjunctiva.
The foremost cell layer of the cornea is the epithelium, which is continuously renewed by the stem cells located at the edge of the cornea (limbus) and can be repaired in case of traumatic defects. Below this is the firming Bowman's layer and the stroma, which ensures the stability of the cornea.
On the underlying Descemet's membrane is the endothelium. This is a single layer of cells whose function is to constantly pump water out of the cornea. This maintains the transparency of the cornea.
The endothelial cells do not renew themselves and, in the event of disease or injury, the cornea may swell (corneal edema) as a result of reduced function, which can lead to worsening of vision and, as it progresses, pain.
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