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Bacterial keratitis
Background
Overview
Definition
Bacterial keratitis is a corneal infection caused by bacteria, characterized by pain, redness, inflammation, and opacity of the cornea.
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Pathophysiology
The pathophysiology of bacterial keratitis involves the entry of bacteria into the cornea, often facilitated by a disruption in the ocular epithelial surface. The bacteria then proliferate and release tissue-damaging proteases and toxins, leading to an inflammatory response.
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Epidemiology
The incidence of keratitis in the US is estimated at 27.6 per 100,000 person-years.
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Risk factors
Risk factors for bacterial keratitis include the use of contact lenses, the presence of ocular surface diseases, ocular trauma, administration of topical corticosteroids, history of ocular surgery, and exposure to certain environmental factors.
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Disease course
Clinically, patients with bacterial keratitis often present with symptoms such as pain, redness, discharge, blurred vision, and photophobia. On examination, suppurative stromal infiltrates with indistinct edges, corneal edema, and white cell infiltration in the surrounding stroma are often observed. An epithelial defect is typically present, and an anterior chamber reaction is often observed.
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Prognosis and risk of recurrence
The prognosis of bacterial keratitis can vary, but it can lead to severe visual impairment if not treated promptly.
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Guidelines
Key sources
The following summarized guidelines for the evaluation and management of bacterial keratitis are prepared by our editorial team based on guidelines from the American Academy of Ophthalmology (AAO 2022,2019), the College of Optometrists (CO 2022), and the American Academy of Family Physicians (AAFP 2016).
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