Bacterial Keratitis: All You Need to Know

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Bacterial Keratitis

Bacterial Keratitis, as the name suggests, is an infection caused by bacteria. It occurs in the cornea of your eye.

It usually develops more quickly than any other type of Keratitis. Sometimes, it may take just a day or two to destroy your cornea.

In the US, approximately 25,000 cases of bacterial Keratitis are reported yearly.

Bacterial Keratitis can be acute, chronic, or transient, depending on the type of bacteria.

Common bacteria that usually cause bacterial Keratitis are Pseudomonas aeruginosa, Streptococcus, and Staphylococcus aureus.

Read on to learn about bacterial Keratitis in detail.

Bacteria are the most common cause of infectious Keratitis.

Symptoms of Bacterial Keratitis

There are not one but many symptoms of bacterial Keratitis, such as:

  • Ocular pain: you can feel the rapid onset of pain in the eye
  • Bloodshot eye: you can see redness in your eye
  • Photophobia: you experience discomfort in bright lights
  • Excessive tearing: your eyes are always watery because of excess tear production
  • Blurred vision: difficulty seeing things clearly 
  • Eye discharge: thick green or gray mucus in your eye
If you notice any of these symptoms, contact your doctor immediately. If bacterial Keratitis is left untreated, it can even lead to blindness.

Causes of Bacterial Keratitis

There are mainly two causes of bacterial Keratitis.

Contact lens

Contact lens is the most common cause of bacterial Keratitis. You can have bacterial Keratitis due to contact lenses if:

  • You wear contact lenses overnight
  • You clean contact lenses inadequately
  • Not disinfecting contact lenses
  • Wearing contact lenses for extended periods
  • Share contact lenses
  • Swim with contact lenses
  • Your contact lens solution gets contaminated

Ocular trauma

Ocular trauma is one of the major causes of bacterial Keratitis. You can get trauma in the following ways:

  • Foreign body injury
  • Chemical, mechanical, and thermal injuries
  • Insect fall
  • Previous ocular and eyelid surgery

Diagnosis of Bacterial Keratitis

Your ophthalmologist can diagnose bacterial Keratitis in the following ways:

Eye exam

swollen eyelid treatmentSource: Brazo_de_Hierro
Eye Checkup

A simple eye exam is the primary diagnostic method that your ophthalmologist will conduct. 

It may be challenging to open your eyes. Still, this primary step has to be taken for further diagnosis or treatment.

Slit lamp examination

The doctor can conduct a slit lamp examination for clinical findings like:

  • Papillary conjunctival reaction
  • Ciliary injection
  • Chemosis
  • A gray-white corneal infiltrate at the epithelial and stromal level surrounded by corneal edema
  • Overlaid by a corneal epithelial defect
  • Anterior chamber reaction 
  • Hypopyon

Corneal scraping

In severe cases of bacterial Keratitis, corneal scraping can be conducted.

In this, cells are collected from the surface of your eye. This helps in further analysis for treatment.

Treatment of Bacterial Keratitis

Mostly, bacterial Keratitis can be treated easily with antibiotics.

The first line treatment of bacterial Keratitis is antibiotic eye drops. 

You could be instructed to take the drops four times daily in moderate circumstances. However, the frequency can increase based on its severity.

Also, oral antibacterial medications may be prescribed in severe bacterial Keratitis cases.

Surgical treatment is also advised when the bacterial Keratitis has advanced.

Your doctor can perform surgeries like a conjunctival flap and therapeutic keratoplasty.

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Risk factors associated with bacterial Keratitis

Certain types of ocular surface diseases are said to be the common risk factors for bacterial Keratitis. 

They are divided into two types: local and systemic.

Allergic ConjunctivitisSource: Inkdrop
allergic conjunctivitis

Local diseases/conditions

  • Dry eyes 
  • Corneal suture-related infection
  • Abnormalities of eyelid anatomy and function 
  • Trichiasis
  • Blepharitis 
  • Chronic dacryocystitis
  • Blepharoconjunctivitis
  • Entropion conjunctivitis
  • Lagophthalmos neurotrophic keratopathy
  • Epithelial defect
  • Recurrent corneal erosions
  • Secondary bacterial Keratitis after viral Keratitis 
  • Bullous keratopathy
  • Ectropion

Systematic diseases/conditions

  • Diabetes mellitus
  • Malnourishment
  • Connective tissue or autoimmune pathologies
  • Steven-Johnson syndrome (SJS)
  • 5th and 7th cranial nerve palsy
  • Atopic dermatitis
  • Immunosuppression (AIDS) 
  • Chronic alcoholism


Bacterial Keratitis is one of the most common infectious Keratitis. It happens due to certain bacteria like Pseudomonas aeruginosa, Streptococcus, and Staphylococcus aureus.

If you wear contact lenses and don’t maintain hygiene, you are at a higher risk of bacterial Keratitis.

Red eye, eye pain, excessive tearing, and eye discharge are some of the common symptoms that one can notice.

Usually, bacterial Keratitis is easily treatable with topical or oral antibiotics. But some severe cases may need surgery.

Frequently Asked Questions

How long does bacterial Keratitis last?

If the bacterial Keratitis is mild, then it won’t last long. With timely treatment and the use of antibiotic eye drops, it may heal within one or two days. However, severe cases can take some time to heal.

How do you treat bacterial Keratitis?

Antibiotics are the first preference for the treatment of bacterial Keratitis. Your ophthalmologist can advise you on antibiotic eye drops or oral medications. Sometimes, in severe cases, surgery can also be performed.

What are the two most common bacteria for bacterial Keratitis?

Several different types of bacteria can cause bacterial Keratitis. The two most common bacteria that can lead to bacterial Keratitis are Pseudomonas aeruginosa and Staphylococcus aureus.

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