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Basics of Bacterial Keratitis

What is bacterial keratitis?

Bacterial keratitis is an infection of the cornea (the clear dome covering the colored part of the eye) that is caused by bacteria. It can affect contact lens wearers, and also sometimes people who do not wear contact lenses. Types of bacteria that commonly cause bacterial keratitis include:

What are the symptoms of bacterial keratitis?

Symptoms of bacterial keratitis include:

  • Eye pain
  • Eye redness
  • Blurred vision
  • Sensitivity to light
  • Excessive tearing
  • Eye discharge

If you experience any of these symptoms, remove your contact lenses (if you wear them) and call your eye doctor right away. If left untreated, bacterial keratitis can result in vision loss or blindness.

Where are these bacteria found?

Bacteria are common in nature and found in the environment and on the human body. Pseudomonas bacteria can be found in soil and water. Staphylococcus aureus bacteria normally live on human skin and on the protective lining inside the body called the mucous membrane. Bacterial keratitis cannot be spread from person to person.

What puts people at risk for bacterial keratitis?

Risks for developing bacterial keratitis include 1, 2:

  • Wearing contact lenses, especially:
    • Overnight wear 3-6
    • Temporary reshaping of the cornea (to correct nearsightedness) by wearing a rigid contact lens overnight, otherwise known as orthokeratology (Ortho-K) 6-9
    • Not disinfecting contact lenses well
    • Not cleaning contact lens cases
    • Storing or rinsing contact lenses in water
    • Using visibly contaminated lens solution
    • "Topping off" lens solution rather than discarding used solution and replacing
    • Sharing non-corrective contact lenses used for cosmetic purposes
  • Recent eye injury
  • Eye disease
  • Weakened immune system
  • Problems with the eyelids or tearing

How is bacterial keratitis diagnosed?

It is critical that when you first notice unusual eye irritation that you remove your contact lenses and not wear them again until instructed to do so by your eye doctor. Your eye doctor will examine your eye. He or she may take a tiny scraping of your cornea and send a sample to a laboratory to be analyzed.

How is bacterial keratitis treated?

In most cases, bacterial keratitis is treated with prescription antibiotic eye drops. Frequent application of antibiotics may be required for severe keratitis 1.

How do you prevent bacterial keratitis?

Follow these tips to keep your eyes healthy while wearing contact lenses. Your daily habits, your contact lenses and supplies, and your eye doctor are all important.

References
  1. American Academy of Ophthalmology Cornea/External Disease Panel. Preferred Practice Pattern® Guidelines. Bacterial Keratitis. San Francisco, CA: American Academy of Ophthalmology; 2013.
  2. Liesegang TJ. Bacterial Keratitis. Infect Dis Clin North Am. 1992;6(4):815-29.
  3. Schein OD, Glynn RJ, Poggio EC, Seddon JM, Kenyon KR. The relative risk of ulcerative keratitis among users of daily-wear and extended-wear soft contact lenses: a case-control study. Microbial Keratitis Study Group. N Engl J Med. 1989;321(12):773-8.
  4. Poggio EC, Glynn RJ, Schein OD, Seddon JM, Shannon MJ, Scardino VA, Kenyon KR. The incidence of ulcerative keratitis among users of daily-wear and extended-wear soft contact lenses. N Engl J Med. 1989;321:779-83.
  5. Stern GA. Contact lens associated bacterial keratitis: past, present, and future. CLAO J. 1998 Jan;24(1):52-6.
  6. Keay L, Stapleton F, Schein O. Epidemiology of contact lens-related inflammation and microbial keratitis: a 20-year perspective. Eye Contact Lens. 2007;33:346-53.
  7. Hsiao CH, Lin HC, Chen YF, Ma DHK, Yeh LK, Tan HY, Huang SCM, Lin KK. Infectious keratitis related to overnight orthokeratology. Cornea. 2005;24:783-8.
  8. Tseng CH, Fong CF, Chen WL, Hou YC, Wang IJ, Hu FR. Overnight orthokeratology-associated microbial keratitis. Cornea. 2005; 24(7):778-82.
  9. Yepes N, Lee SB, Hill V, Ashenhurst M, Saunders PP, Slomovic AR. Infectious keratitis after overnight orthokeratology in Canada. Cornea. 2005 Oct;24(7):857-60.
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