When is corneal irrigation indicated in keratitis?
Jun 29, 2022
Source: Cainiu Health
Dr. Wang Shuai
Introduction
Keratitis can be irrigated during the active phase of the disease. However, care must be taken to avoid water entering the eye, as this may exacerbate corneal contamination and worsen inflammation. Keratitis is an inflammatory condition affecting the cornea—the transparent, dome-shaped front surface of the eye. Its main clinical manifestations include conjunctival injection (redness), ocular discharge, photophobia, excessive tearing, blepharospasm, decreased visual acuity, significant ocular pain, and a foreign-body sensation.
Keratitis is a common ophthalmic condition encountered in clinical practice. It is primarily caused by bacterial or viral infection of the cornea. Keratitis can cause the normally transparent cornea to become opaque and white, thereby obstructing light entry into the eye. Patients typically present with blurred vision; severe cases may progress to blindness. Under what circumstances is irrigation indicated for keratitis?
When Is Irrigation Indicated for Keratitis?
Irrigation may be performed during the active phase of keratitis. However, care must be taken to avoid allowing water to enter the eye—especially during bathing—as this may exacerbate contamination of the cornea and worsen inflammation. Keratitis involves inflammation of the black portion of the eye (i.e., the cornea). Key clinical manifestations include conjunctival injection (redness), ocular discharge, photophobia, epiphora (excessive tearing), blepharospasm, decreased visual acuity, marked ocular pain, and a foreign-body sensation. For keratitis, irrigation of the eye may be performed using a 3% boric acid solution or normal saline.
Clinical features of keratitis include red eye, ocular pain, foreign-body sensation, conjunctival sac discharge, photophobia, epiphora, and decreased visual acuity—typical signs of ocular irritation. When copious discharge accumulates in the conjunctival sac, irrigation with normal saline or a 3% boric acid solution may be used to reduce bacterial load within the sac. During irrigation, avoid directing the saline solution directly onto the cornea to prevent further corneal injury. While irrigating, instruct the patient to rotate their eyes, and the clinician should gently evert both upper and lower eyelids to ensure thorough irrigation of the entire conjunctival sac. Following irrigation, apply an antibiotic ointment into the conjunctival sac to protect the cornea.
Patients diagnosed with keratitis are strongly advised to seek comprehensive evaluation at a hospital to determine the specific etiology and type of keratitis, enabling targeted and effective pharmacotherapy.
