KERATITIS Keratitis Inflammation of cornea characterized by moderate

KERATITIS

Keratitis � Inflammation of cornea characterized by moderate to intense pain and impaired vision

Types � Superficial keratitis – involves the superficial layers of the cornea and not generally leave a scar � Deep keratitis – deeper layers of the cornea (bowman’s membrane and other deep layers) and leave a scar that impairs vision

Causes Based on pathogens Amoebic keratitis – � Usually affecting contact lens wearers � Caused by acanthamoeba (acanthamoeba keratitis)

� Bacterial keratitis – staphylococcus aureus, pseudomonas aeruginosa � Fungal keratitis – aspergillus Viral keratitis - HSV � Dendritic keratitis or herpes simplex keratitis – usually leaves a dendritic ulcer � Herpes zoster keratitis – herpes zoster virus

� Exposure keratitis – due to dryness of the cornea caused by incomplete or inadequate eyelid closure (in exophthalmos or masses inside the globe) � Photokeratitis – keratitis due to intense ultraviolet radiation exposure

Signs and symptoms � Pain � Tearing � Redness and blurring of vision � The pain may be mild to severe, depending on the cause and extent of the inflammation � Sensitivity to light may also be present

Management Antibacterial therapy � Topical antibiotics, subconjunctival antibiotic injection or in severe cases – IV antibiotics � Sub conjunctival injection – 25 G needle and 2 ml syringe.

� Antiviral therapy – topical acyclovir � analgesics for pain � Corticosteroids to reduce inflammation Antifungal therapy � Natamycin – antifungal eye drop is the only treatment for acanthamoeba keratitis. Because all other drugs are resistant to acanthamoeba � If that treatment fails – keratoplasty

Nursing management for eye inflammations and infections Assessment -Assess ocular changes – � Edema � Redness � Decreasing visual acuity, � Feeling of foreign body � Discomforts

Nursing diagnosis � Acute pain related to irritation or infection of the eye � Anxiety related to outcome of treatment � Disturbed sensory perception (visual) related to diminished vision � Knowledge deficit

Interventions Health promotion � Aseptic technique � Frequent thorough hand washing – to avoid spreading � Dispose contaminated dressings � If the patient is having any STD’s, they are more risky

� Apply warm or cool compresses if indicated � Darkening the room and providing appropriate analgesic – comfort measures � If the patient receives one or more eye drops – proper spacing should be given in between dosages – help and promote maximum absorption

� Teach family regarding the safety measures and medication techniques � Do not share eye cosmetics � Do not share contact lens � Clean the contact lens properly and store it in a closed container.