Bacterial and Fungal Keratitis
Bacterial and Fungal Keratitis
Hi everyone, my name is Dr. Beeran Meghpara and I am a cornea specialist here at Wills Eye Hospital in Philadelphia, PA. With summer just around the corner, I’m here today to talk about a corneal problem called keratitis, which we tend to see more of as the weather warms up. Now keratitis is a pretty broad term, and it basically means inflammation in the cornea that can be caused by a wide variety of things. Severity can range from a minor annoyance to a devastating sight threatening infection.
On the cornea service here at Wills, during the warmer months of summer we see more contact lens related problems and contact lens related keratitis. On the mild end of the spectrum, simply overusing your contact lenses can lead to irritation and inflammation on the corneal surface that patients experience as a red and uncomfortable eye. Fortunately, this can resolve on it’s own by simply giving your corneas a break and staying out of contact lenses. However, if the problem is more severe, leading to pain, light sensitivity, discharge from the eye, or vision loss, we worry about an infection in the cornea. The warm and humid weather is an ideal environment for bacteria to grow on contact lenses or even in contact lens cases, and if you are not careful the infection can invade the cornea resulting in a severe condition called bacterial keratitis, which can become very aggressive and if not treated can lead to loss of vision.
Bacteria are not the only organisms that can infect the cornea. Fungus and parasites can both cause severe and very difficult to treat keratitis. Both of these thrive in the summer as well. Fungus is found all around us, in the soil, on plants, and in water. We often see fungal keratitis occur after an injury to the cornea involving plant material. One example is getting hit in the eye with a tree branch. Acanthamoeba is a parasite we worry about a lot, especially in contact lens users. Acanthamoeba keratitis, fortunately is rare, but it is notoriously difficult to treat. The classic example we see in the summer is a patient who went swimming in a fresh water lake while wearing their contact lenses and a few days later developed severe pain and vision loss. The contact lens essentially acts like a sponge picking up the amoeba and placing it right on top of the cornea giving it access to cause an infection.
The most effective treatment of all of these is prevention. Try to limit the number of hours per day you wear your contacts and absolutely do not sleep in your contact lenses. Make sure you take your lenses out each night and clean them properly with a cleaning solution recommend by your eye doctor. Never use tap water or saliva to clean your lenses or your contact lens case. Avoid swimming, showering, or going in hot tubs while wearing your contact lenses. When you are outdoors, wear sunglasses, not only does this block ultraviolet light from your eyes, but it also reduces the risk of an injury to your cornea from things like tree branches or flying debris.
If you think you are having a problem, for example if your eye is red and painful or if you recently had an injury to your eye, please see your ophthalmologist right away. The sooner the problem is caught, the better chance we have to stop it. We can perform a thorough eye exam to determine if there are signs of an infection. Often times we take a small sample of the infected area and send it to our lab to culture it. Basically we are trying to determine if is the cornea infected, and if it is, what is causing the infection. Is it a bacteria, a fungus, a parasite? Treatment usually starts with the frequent application of one or more eye drops. If the infection is severe enough and drops are not effective, we may need to perform surgery, including corneal transplantation. In some cases, even corneal surgery will not restore vision. In these cases, permanent vision impairment may occur. That is why it is so important to see your ophthalmologist at the first sign of any ocular infection.
Thank you for your attention and from all of us here at Wills Eye Hospital we wish you a healthy and safe summer.