What Is Bacterial Keratitis?

Bacterial keratitis is a purulent keratitis caused by bacterial infection, also known as bacterial corneal ulcer. The condition is more critical, if not treated effectively, corneal ulcer perforation, even intraocular infection, and eventually eye atrophy.

Basic Information

nickname
Bacterial corneal ulcer
English name
bacterial keratitis
Visiting department
Ophthalmology
Common causes
Infections after trauma or infections after removal of corneal foreign bodies
Common symptoms
Redness, pain, photophobia, tearing, decreased vision, eyelid spasm, and increased secretions, etc.

Causes of bacterial keratitis

Mostly caused by infection after trauma or infection after removal of corneal foreign bodies.
Common pathogenic bacteria
Staphylococcus, Micrococcus, Streptococcus, Pseudomonas, etc.
2. Conditional pathogens
Due to the excessive use of antibiotics and glucocorticoids, some condition-causing pathogens such as Streptococcus aureus, Klebsiella, and Diphtheria pneumoniae have become increasingly infected.
3. Some eye diseases and systemic diseases
Such as dry eye, chronic dacryocystitis, diabetes, etc. can also cause increased corneal susceptibility to bacteria.

Clinical manifestations of bacterial keratitis

Onset time
Sudden onset, often onset 24-48 hours after corneal trauma.
2. Symptoms
Redness, pain, photophobia, tearing, decreased vision, eyelid spasm, and increased secretions.
3. Signs
Eyelid swelling, bulbar conjunctival edema, ciliary congestion, or mixed congestion. In the early stage of the lesion, a well-defined epithelial ulcer appeared on the cornea. Under the ulcer, there was a blurred, dense gray-yellow infiltration of the border, and the surrounding tissue was edema. The infiltrates quickly expanded, forming ulcers. Corneal ulcers develop deeper. When a perforation is about to occur, a thin layer of transparent tissue may appear at the base of the ulcer and bulge forward, which is called posterior elastic membrane bulge. When the cornea is perforated, the patient feels severe pain and "hot tears" (aqueous humor), and the anterior chamber after perforation. For severe corneal inflammation or corneal ulcers, the toxins entering the anterior chamber can stimulate inflammation of the iris ciliary body. Iris ciliary body hyperemia, edema, vascular permeability changes, cells infiltrate into the aqueous humor, mild humor, or posterior corneal deposits; in severe cases, there are a large number of purulent exudates deposited at the bottom of the anterior chamber, said Anterior chamber purulent corneal ulcers, if left untreated, can produce post-iris adhesions.

Bacterial keratitis test

Lesion scrape examination can quickly diagnose the disease. Using a sterile cotton swab to take a sample of the edge of the eyelid and conjunctival sac or use a Kimura or Lindner spatula to take a smear from the bottom and edge of the ulcer (secret or necrotic tissue) can quickly determine the source of bacterial infection.

Diagnosis of bacterial keratitis

The final diagnosis of the disease must be determined by bacterial culture.

Bacterial keratitis treatment

Acute eye drops with high concentrations of antibiotic eye drops frequently (every 15 to 30 minutes), in severe cases, within the first 30 minutes, once every 5 minutes, the antibiotic treatment concentration can be achieved in the matrix. After the condition is controlled, the number of medications is gradually reduced. During the treatment process, effective antibiotics should be adjusted and used according to the results of bacteriological examination and drug sensitivity test. You can wear antibiotic eye ointment at night.
Drug treatment is ineffective, the condition develops rapidly, and those who may cause ulcer perforation may consider therapeutic corneal transplantation.

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