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.