Introduction
Rarer than conjunctivitis is corneal inflammation. However, it can permanently impair vision, making corneal inflammation more dangerous than conjunctivitis. Normally, an intact cornea is protected by its natural defenses, so that an undamaged cornea is not usually inflamed.
A slit lamp is used to illuminate the widely opened eye. The light searches for whitish ulcers in the cornea. It may also be possible to see pus in the anterior chamber of the eye between the cornea and the iris.
- Wearing contact lenses too often/too long or with a poor fit
- Herpes Viruses
- Fungal infections
- Dry eyes (= increased friction)
- Insufficient eyelid closure (= drying of the cornea)
- Irritation/injuries caused by foreign bodies
- Rheumatic diseases
In many cases there is an infection with germs, which can lead to corneal inflammation. Anyone who has a corneal inflammation caused by germs is contagious for an average of two weeks after the onset of the disease and can continue to carry the bacteria, viruses or fungi. This happens simply through the tear fluid.
For this reason, rubbing the eyes should be avoided so that the infectious tear secretion, which is then found on the hands, is not transmitted when shaking hands or touching objects. Frequent hand washing can also help to avoid spreading. However, there are also non-infectious causes of corneal inflammation, such as eyes that are too dry, which can also irritate the cornea.
Since there are no germs as a cause, no infection is possible. Nevertheless, one should still pay attention to proper hygiene. Typical signs of corneal inflammation are: burning pain red eyes foreign body sensation in the eye: usually the sensation of rubbing sandpaper or grains of sand in the eye is described photophobia (photophobia) formation of tears or other secretions and mucus While vision is not impaired in conjunctivitis, it can be aggravated in corneal inflammation.
In the worst case, it is even possible for blood vessels to form in the eye or accumulate fluid, which in the long term can lead to blindness or an ulcer. A striking symptom of almost every inflammation is pain. In corneal inflammation, the cornea as the top layer is irritated or damaged, which causes the nerve endings on the surface to be exposed, leading to the painful discomfort.
- Burning pain
- Red eyes
- Foreign body sensation in the eye: usually the feeling of rubbing sandpaper or grains of sand in the eye is described
- Photophobia (light aversion)
- Formation of tears or other secretions and mucus
As soon as corneal inflammation is suspected, an eye doctor should be consulted immediately. The infection must be detected in time so that vision can be preserved and targeted treatment can be given. After corneal inflammation, scars often form which can lead to a permanent reduction in vision.
Depending on the severity of the inflammation and the timing of treatment, the duration of therapy can vary. However, adequate treatment usually lasts from a few days up to two to four weeks. Contact lens wearers should not wear the lenses at least for the duration of treatment.
If hygiene is inadequate, contact lenses are a breeding ground for germs. For the future, care should also be taken to change the disinfecting liquid and also the lens containers regularly. Before inserting and removing the lenses, it is recommended to wash your hands thoroughly to avoid a new corneal inflammation.
In the worst case, blindness or other limitations of the eye can occur, which is irreversible. Therefore, an early visit to the doctor is of enormous importance for the therapy and thus also for the duration. Depending on the cause, the different forms of corneal inflammation (keratitis) require different therapies: Corneal inflammation caused by bacteria (bacterial keratitis) Most infection-related inflammations of the cornea are caused by bacteria.The most common pathogens are staphylococci and pneumococci, and the cornea is particularly at risk when infected with Pseudomonas aeruginosa.
To treat bacterial corneal inflammation, antibiotic eye ointment is often prescribed, such as Floxal eye ointment. Except for exceptions such as gonococci, which can cause severe infections, especially in newborns, a bacterial infection usually requires the surface of the cornea to be damaged so that the pathogens can penetrate the cornea. For this reason, bacterial corneal inflammation is most common due to contact lenses, corneal injury, weakened immune system or inflammation/displacement of the lacrimal ducts.
The patient often notices light sensitivity, eyelid cramps and severe pain when there is a bacterial infection of the cornea. The conjunctiva is also severely reddened. The ulcer on the cornea that can be seen during the examination is visible as a depression and is usually greyish in color with a surrounding ring wall.
Often there is also pus in the anterior chamber of the eye and can be seen behind the cornea as a whitish yellow deposit at the lower edge (hypopyon). In the worst case, the corneal ulcer can break through to the inside, causing the cornea to open (perforation, perforating ulcer). The aqueous humor, which is located in the eye chambers, flows out through this and the iris (iris) lies in the opening.
However, even without opening of the cornea, the iris can stick to the cornea in case of severe inflammation of the cornea and an increase in intraocular pressure, the so-called glaucoma, can occur. As an examination, a short eye test is performed after the medical history, the eye is examined and a smear of the cornea is taken, which is sent to the laboratory. There, the pathogen can be examined and then treatment with specifically suitable antibiotics, e.g. with Refobacin®, follows.
Since corneal inflammation can cause massive consequential damage, it is recommended to start antibiotic therapy with standard preparations in the form of eye drops that are effective against many types of bacteria even before the exact pathogen is known. It may also be advisable to administer antibiotics as an injection under the conjunctiva. As soon as the results of the laboratory examination are known, the selection of antibiotic drugs can be adjusted to the exact pathogen.
Except in cases of infection with Pseudomonas, additional therapy with cortisone must not be used. In very severe cases, when an opening (perforation) of the cornea is to be feared or has even already occurred, an emergency corneal transplant may be necessary. This is also possible for scars in the cornea caused by previous inflammation.
Depending on the cause of the corneal inflammation, a doctor will prescribe the appropriate eye drops. For dry eyes, a conventional preparation can be used for moistening. The drops should help to put a protective film on the eye.
However, if the cause is a pathogen, eye drops must be combined with certain medications. In the case of bacteria, an antibiotic is used, in the case of fungi an antifungal agent and in the case of viruses a viral agent to combat the pathogens. If it is a herpes virus, it may also be necessary to take additional tablets.
Since this is a very serious and potentially dangerous disease of the eye, treatment with home remedies should only be carried out in principle as an accompaniment to medical therapy and should be discussed in advance with the treating doctor. In order to combat burning and itching of the eyes, numerous aids that have a cooling effect can be used. No matter whether quark compresses, cool packs or cold compresses and envelopes with water.
Those who feel that warmth is more likely to help can also try this with the help of compresses. In addition, eye showers can be used to flush out pus or clean a blocked tear duct. As a matter of principle, the rooms in which you are staying should also be darkened or sunglasses should be worn to protect the eyes.
Computer screens, television screens, etc. should be avoided as far as possible and homeopathic remedies are also a possibility to supplement the therapy, but should never be the sole main therapy. Since blindness can occur in the worst case, it is very important to see an eye doctor.
After consultation with the treating ophthalmologist, homeopathic remedies can still be used. If you like, you can use eye drops or tea infusions.Eyebright (Euphrasia) is particularly popular for this purpose. But also other plants like calendula or celandine are used here.
Sometimes chamomile is also recommended, but it also has potentially irritating properties on the eye and should only be used on the eyelid if possible. All these medicinal plants can be conveniently infused as tea, so that the tea bag can be placed on the eyelid for application. With a compress, the teas can be applied comfortably on the eye.
Sick leave can be a useful method to speed up the healing process. Usually, it is recommended to take a sick leave for about 2 weeks, because the eyes need this period of time for the inflammation to heal by the time you go back to work, school or daycare. However, this applies more to viral corneal inflammation, as this can be very contagious. If corneal inflammation is caused by fungi, the risk of transmission is less high. Here too, however, a two-week sick leave is possible.
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