Oct222025
Bacterial keratitis treatment

Everything You Need to Know About Bacterial Keratitis: The Silent Corneal Infection

Bacterial keratitis is an infection of the cornea, the clear “window” covering the iris, caused by bacteria. It is sometimes called a corneal ulcer when tissue loss occurs. Because early symptoms like redness or mild irritation can be subtle, bacterial keratitis has been dubbed a “silent corneal infection.”

Left untreated, it can progress rapidly and threaten vision. Corneal destruction can occur within 24–48 hours with aggressive bacteria. Globally, microbial keratitis (including bacterial keratitis) is a leading cause of unilateral blindness, with an estimated 2.0–3.5 million cases occurring worldwide each year. Cases are rising, often linked to increased contact lens use and environmental exposures. Early detection and prompt treatment are critical, as untreated bacterial keratitis may lead to scarring or permanent vision loss.

Causes and Risk Factors

Bacterial keratitis occurs when bacteria invade the cornea, usually through a break in its outer layer. Common bacteria include Staphylococcus, Streptococcus, and Pseudomonas.

Key risk factors include:

  1. Contact lens wear: Improper use of soft lenses is the single biggest risk factor. Sleeping in lenses, “topping off” old solution, or swimming with lenses on all increase the risk.
  2. Eye trauma: Scratches, foreign bodies, or chemical burns disrupt the corneal surface and allow bacteria to enter. Sports injuries and accidents are common causes in children.
  3. Poor hygiene: Touching eyes with unwashed hands or using contaminated eye drops/solutions introduces bacteria. Rinsing contacts with tap water dramatically increases risk.
  4. Ocular surface disease: Chronic dry eye, lid disorders (e.g., misdirected eyelashes), or eyelid inflammation weaken corneal defences. Eye surgeries or long-term steroid use also predispose the cornea to infection.
  5. Immune compromise: Patients with weakened immunity (diabetes, HIV, or immunosuppressant drugs) are more susceptible.
  6. Environmental factors: Dusty or contaminated environments (soil, polluted water) can carry bacteria that infect minor corneal abrasions. Warm, humid climates may further promote bacterial growth near the eye.

By addressing these risk factors, for example, following proper contact lens care, the likelihood of bacterial keratitis can be greatly reduced.

Symptoms to Watch For

Bacterial keratitis usually develops suddenly and worsens quickly. Key symptoms include:

  • Eye pain: Often sharp and severe, sometimes disproportionate to any visible injury.
  • Redness: Significant conjunctival injection, especially around the cornea.
  • Blurred vision: Cloudy or hazy vision if the central cornea is affected.
  • Light sensitivity: Discomfort or pain in bright light (photophobia).
  • Tearing or discharge: Eyes may water excessively or produce yellow/green pus-like discharge.
  • Foreign-body sensation: Feeling like sand or dust is in the eye, even when nothing is present.

Unlike minor irritation, symptoms intensify rapidly. A small red spot can become a larger ulcer within a day, sometimes accompanied by hypopyon (pus in the eye). If you notice any combination of pain, redness, and vision change, seek immediate evaluation. Even mild but worsening eye discomfort warrants attention.

Diagnosis and Medical Assessment

An ophthalmologist will perform a thorough eye exam to confirm bacterial keratitis. The process typically includes:

  • History taking: Assessing contact lens habits, eye injuries, or immune conditions.
  • Slit-lamp examination: High-magnification inspection reveals infiltrates or ulcers not visible to the naked eye.
  • Fluorescein staining: Yellow-green dye highlights corneal defects under blue light.
  • Corneal culture/scraping: Identifies the bacteria and antibiotic sensitivities, crucial for severe, deep, or unusual ulcers.

Early diagnosis is vital, as corneal destruction can occur within 1–2 days if untreated. Prompt identification and treatment greatly improve the chance of preserving vision.

Treatment Options

Bacterial keratitis requires aggressive and immediate treatment to eliminate infection, relieve pain, and preserve vision:

  1. Topical antibiotics: Broad-spectrum drops (ciprofloxacin, ofloxacin, moxifloxacin) are often given hourly at first. Severe ulcers may require “fortified” antibiotics like vancomycin or tobramycin. Therapy is adjusted based on lab results.
  2. Oral antibiotics: Used if deeper eye structures are affected or if the infection is severe.
  3. Pain and inflammation control: Cycloplegic drops and oral pain medications relieve discomfort. Steroids may be introduced only after 24–48 hours of confirmed antibiotic therapy.
  4. Intensive follow-up: Daily or alternate-day visits monitor healing. Adjustments to treatment are made as needed.
  5. Surgical interventions: Emergency procedures like corneal glueing, lamellar or full-thickness transplants, or tissue engineering may be necessary for large, non-healing, or perforated ulcers.

Strict adherence to prescribed therapy and follow-ups is essential to ensure full recovery and prevent recurrence.

Prevention Tips

Prevent bacterial keratitis by minimising risk factors:

  • Contact lens hygiene: Wash hands, clean lenses daily with fresh solution, replace cases every 1–3 months, and avoid sleeping or swimming in lenses.
  • Protective eyewear: Use goggles or safety glasses for sports, workshops, or swimming.
  • Avoid eye rubbing: Use lubricating drops instead of rubbing irritated eyes.
  • Screen breaks and moisture: Blink regularly, use artificial tears, and rest eyes from prolonged screens.
  • Manage chronic eye conditions: Clean eyelids and follow the doctor’s instructions for dry eye or blepharitis.
  • Prompt care for injuries: Even minor abrasions should be examined to prevent infections.

How Maxivision Eye Hospitals Treats Bacterial Keratitis

At Maxivision Eye Hospitals, we treat bacterial keratitis as an emergency. Our cornea specialists, including pediatric ophthalmologists, use advanced diagnostics and treatments for fast, effective care.

We perform thorough slit-lamp exams and corneal cultures immediately, then start intensive topical antibiotics, adjusting therapy based on lab results. Severe cases may include oral antibiotics or anti inflammatory treatments.

We emphasise personalised care, with child-friendly protocols, pediatric dosing, and explanations suitable for kids and adults alike. Surgical interventions like corneal gluing or transplants, are available when necessary.

Patient education and follow-up are central to our approach. We guide families on proper eye drop administration, hygiene, and frequent check-ups until complete healing. By combining expertise, technology, and compassionate care, we maximize treatment success.

FAQs

Yes. Untreated infection can scar or perforate the cornea, causing permanent vision impairment
 or blindness.

Immediately. Bacterial keratitis can escalate within 24–48 hours.

Definitely. Improper lens hygiene and extended wear are the leading causes.

Yes. Good lens hygiene, hand-washing, protective eyewear, and prompt treatment of eye
 irritation significantly reduce risk.

Our experienced cornea specialists, modern diagnostic tools, and patient-focused care ensure effective and safe recovery. We educate patients, monitor progress closely, and prevent future
 infections.

Conclusion

Bacterial keratitis is a serious corneal infection, but early detection and proper care can save vision. Watch for redness, pain, discharge, or blurred vision, and seek prompt examination. By practising good hygiene and preventive habits, families can greatly reduce the risk of infection.

At Maxivision Eye Hospitals, we combine specialist expertise, cutting-edge diagnostics, and compassionate follow-up to treat bacterial keratitis effectively. With timely care, patients, both children and adults, can protect their vision and enjoy long-term eye health.