Referat

KERATITIS

By:
Widya Melianita ( 17360158)

Perceptor:
dr. Rahmat Syuhada, Sp.M
Anatomy and Physiology of the Cornea
 Keratitis
Definition

Keratitis is inflammation of the cornea due to

infiltration of inflammatory cells in the cornea
which will cause the cornea to become turbid. So
the vision is decreases.
1. Virus
2. Bacteria
3. Fungal
4. Exposure to ultraviolet light
5. Irritation of contact lenses
6. Dry eyes
7. The presence of a foreign object in the eye
8. Reactions to drugs such as neomycin, tobramycin,
pollution, or airborne particles such as dust, pollen

Etiology
 Pain light-heavy
Photophobia
Watery eyes and dirty
Lesions in the cornea
Vision decreases

Common symptoms of keratitis

 Corneal injury
Pathophysiology
Stromal cells into macrofag

Perichornea injection occurs Dilatation of blood vessels in

the limbus

Arising infiltrates such as dark grey

patches with non-slippery surfaces

Corneal epithelial damage occurs and

ulcers arise that spread to the surface
in the stroma

If inflammation is great

Toxins from the cornea can spread to

the iris and ciliary bodies

Inflamed and arising turbidity If it continues to deeply

in the CoA, followed by the arise protrusion membrane
formation of hypopion decement (descementocele)
Classification
Bacterial Keratitis
Etiology
Clinical Manifestations
red eyes
Watery eyes
Pain in the infected eye
Photophobia
The presence of secretions
Vision decreases
Management
Fungal Keratitis
Most fungi are caused by Fusarium, Filamentous,
Yeast, Candida, Aspergillus

Symptoms: severe eye pain, watery eye, decreased

vision and photophobia

Visible grey infiltrates, accompanied by hypopion,

inflammation, superficial ulceration and satellites
Management
Anti-fungal medicines that can be given
include :
Polyenes include natamycin, nystatin, and
amphotericin B.
Azoles (imidazoles and triazoles) include
ketoconazole, Miconazole, fluconazole,
itraconazole, econazole, and clotrimazole
Virus Keratitis
Etiology

Herpes Simplex Virus (HSV) is one of the

most common viral infections of the
cornea
Keratitis caused by herpes simplek divided into
2 forms:
Clinical Manifestations

pain
Photophobia
Blurred vision
watery eyes
Red eyes
Vision goes down especially if the central part is
affected
Management
Debridement

Drug Therapy
IDU (Idoxuridine) pyrimidine analogue (found in 1% solution and
given every hour, 0.5% ointment given every 4 hours)
Vibrabin: same as IDU but only available in ointment form
Trifluorotimetidine (TFT): same as IDU, given 1% every 4 hours
Acyclovir (3% ointment), given every 4 hours.
Oral acyclovir may be useful for severe eye-ophthalmia,
particularly in atopic people who are prone to aggressive eye and
skin diseases.

Surgical Therapy
Penetrans keratoplasty may be indicated for vision rehabilitation
of patients with severe corneal scarring
Allergy Keratitis
Etiology

Type I hypersensitivity reactions that affect both

eyes,
Usually patients often show symptoms of allergy
to grass pollen
Clinical Manifestations
The shape of palpebra: cobble stone (large
papillary growth), covered by mukoid
secretions.
Limbus shape: tantras dot (protrusion grey,
like a candle)
Itchy
Photophobia
Sensation of foreign object
Watery eyes and blefarospasme
Management
It usually heals itself untreated
Topical and systemic steroids
Cold compress
Vasoconstrictor medicine
Topical sodium cromolyn
Small surgery (excision).
Antihistamines
Contraindications for the installation of
contact lenses
Classification
Flikten Keratitis
It is an inflammation of the cornea and conjunctiva as an
immune reaction that cells may be mediated in tissues that
are already sensitive to antigens.

Symptoms:
Lacrimation & photophobia accompanied by pain,
conjunctival hyperemia, thickened corneal epithelium, heat
sensation as well as itching and diminished vision.

In the limbus there is a white grey lump surrounded by a

hyperemic conjunctival area.
Sika Keratitis
It is an inflammation of the conjunctiva and cornea due to the dry surface
of the cornea and conjunctiva.
This disorder occurs in the resulting disease:

Reduced fat components, such as blepharitis

Reduced tears, as in the syndrome of syrogen, after taking diuretic

drugs, atropine or reached in old age.

Reduced components of mucin

Excessive evaporation such as in desert life, lagoftalmus, neuroparalitic

keratitis.

The presence of sikatrik on the cornea.

Numularis Keratitis
Clinically, the signs of inflammation are unclear, There is a
subepithelial round infiltrate in the cornea, where the center is
clearer, called halo (presumably due to resorption of the
infiltrates that begin in the middle).

Fluorescent test (-).

This keratitis when healed leave a mild sikatrik

 Itis keratitis due to trigeminal nerve activity in
the presence of an insensitive corneal clouding
with corneal drought.

Symptoms: decreased vision, photophobia, no

pain. Loss of flashing reflex, ciliary injection,
cornea cloudy surface, infiltrates and vesicles in
the cornea.

Neuroparalitik
Keratitis
Complications
Refraction
Permanent
Corneal
Secondaryperforation
ulcers
disorder
glaucoma
scarring
Prognosis

Keratitis can heal properly

Thank you