KERATITIS

UPF. Kornea, Infeksi & Imunologi

Rumah Sakit Mata Cicendo
Fakultas Kedokteran
Universitas Padjadjaran Bandung
 CORNEAL INFECTIONS
1. Bacterial keratitis
2. Fungal keratitis
3. Acanthamoeba keratitis
4. Infectious crystalline keratitis
5. Herpes simplex keratitis
-Epithelial
-Disciform
6. Herpes zoster keratitis
Bacterial keratitis
Predisposing factors :
• Contact lens wear
• Chronic ocular surface disease
• Corneal hypoaesthesia

Expanding oval, yellow-white, Stromal suppuration and

dense stromal infiltrate hypopyon

Treatment
- topical ciprofloxacin 0.3% or ofloxacin 0.3%
 Fungal keratitis
Frequently preceded by ocular trauma with organic matter

Greyish-white ulcer which may be Slow progression and occasionally

surrounded by feathery infiltrates hypopyon

• Topical antifungal agents

Treatment • Systemic therapy if severe
• Penetrating keratoplasty if unresponsive
Acanthamoeba keratitis
• Contact lens wearers at particular risk
• Symptoms worse than signs

Small, patchy anterior Perineural infiltrates

stromal infiltrates (radial keratoneuritis)

Ulceration, ring abscess Stromal opacification

& small, satellite lesions

Treatment- chlorhexidine or polyhexamethylenebiguanide

Herpes simplex epithelial keratitis

• Dendritic ulcer with terminal bulbs • May enlarge to become

• Stains with fluorescein geographic

• Aciclovir 3% ointment x 5 daily

• Trifluorothymidine 1% drops 2-hourly
Treatment
• Debridement if non-compliant
 Herpes simplex disciform keratitis
Signs Associations

Central epithelial and stromal oedema • Occasionally surrounded by

• Folds in Descemet membrane Wessely ring
• Small keratic precipitates

Treatment - topical steroids with antiviral cover

 Herpes zoster keratitis
Acute epithelial keratitis Nummular keratitis

• Develops in about 50% within • Develops in about 30% within

2 days of rash 10 days of rash
• Multiple, fine, granular deposits
Small, fine, dendritic or stellate
epithelial lesions just beneath Bowman membrane
• Tapered ends without bulbs • Halo of stromal haze
• Resolves within a few days • May become chronic

Treatment - topical steroids, if appropriate