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Interstitial keratitis

Keratitis interstitial

 

Interstitial keratitis is inflammation of the tissue of the cornea, the clear window on the front of the eye. The condition can lead to vision loss.

Causes

 

Interstitial keratitis is a serious condition in which blood vessels grow into the cornea. Such growth can cause loss of the normal clearness of the cornea. This condition is often caused by infections.

Syphilis is the most common cause of interstitial keratitis, but rare causes include:

  • Autoimmune diseases, like rheumatoid arthritis and sarcoidosis
  • Leprosy
  • Lyme disease
  • Tuberculosis

In the United States, most cases of syphilis are recognized and treated before this eye condition develops. However, interstitial keratitis remains the most common cause of blindness in the world.

 

Symptoms

 

Symptoms may include:

  • Eye pain
  • Excessive tearing
  • Sensitivity to light (photophobia)

 

Exams and Tests

 

Interstitial keratitis can be easily diagnosed by slit-lamp examination of the eyes. Blood tests and chest x-rays will usually be needed to confirm the infection or disease that is causing the condition.

 

Treatment

 

The underlying disease must be treated. Treating the cornea with corticosteroid drops may minimize scarring and help keep the cornea clear.

Once the active inflammation has passed, the cornea is left severely scarred and with abnormal blood vessels. The only way to restore vision at this stage is with a cornea transplant.

 

Outlook (Prognosis)

 

Diagnosing and treating interstitial keratitis and its cause early can preserve the clear cornea and good vision.

 

Possible Complications

 

A corneal transplant is not as successful for interstitial keratitis as it is for most other corneal diseases. The presence of blood vessels in the diseased cornea brings white blood cells to the newly transplanted cornea and increases the risk of rejection.

 

When to Contact a Medical Professional

 

All people with interstitial keratitis will be closely followed by an ophthalmologist and a medical specialist with expertise in the underlying disease. Any worsening pain, increasing redness, or decreasing vision should be evaluated immediately. This is particularly crucial for people with corneal transplants.

 

Prevention

 

Prevention consists of avoiding the infection that causes interstitial keratitis. If you do get infected, get prompt and thorough treatment and follow-up.

 

 

References

Bouchard CS. Noninfectious keratitis. In: Yanoff M, Duker JS, eds. Ophthalmology. 3rd ed. St. Louis, MO: Elsevier Mosby; 2008:chap 4.17.

Ginsberg SP. Corneal problems in systemic disease. In: Tasman W, Jaeger EA, eds. Duane's Ophthalmology. 2013 ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2013:chap 43.

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    Tests for Interstitial keratitis

     
       

      Review Date: 9/2/2014

      Reviewed By: Franklin W. Lusby, MD, Ophthalmologist, Lusby Vision Institute, La Jolla, CA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

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