Interstitial keratitis is inflammation of the tissue of the cornea, the clear window on the front of the eye. The condition can lead to vision loss.
Keratitis interstitial; Cornea - keratitis
Interstitial keratitis is a serious condition in which blood vessels grow into the cornea. Such growth can cause loss of the normal clearness of the cornea. This condition is often caused by infections.
Syphilis is the most common cause of interstitial keratitis, but rare causes include:
In the United States, most cases of syphilis are recognized and treated before this eye condition develops.
However, interstitial keratitis accounts for 10% of avoidable blindness in the least developed countries worldwide.
Symptoms may include:
The underlying disease must be treated. Treating the cornea with corticosteroid drops may minimize scarring and help keep the cornea clear.
Once the active inflammation has passed, the cornea is left severely scarred and with abnormal blood vessels. The only way to restore vision at this stage is with a cornea transplant.
Diagnosing and treating interstitial keratitis and its cause early can preserve the clear cornea and good vision.
A corneal transplant is not as successful for interstitial keratitis as it is for most other corneal diseases. The presence of blood vessels in the diseased cornea brings white blood cells to the newly transplanted cornea and increases the risk of rejection.
People with interstitial keratitis need to be followed closely by ophthalmologist and a medical specialist with knowledge of the underlying disease.
A person with the condition should be checked immediately if:
This is particularly crucial for people with corneal transplants.
Prevention consists of avoiding the infection that causes interstitial keratitis. If you do get infected, get prompt and thorough treatment and follow-up.
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Gauthier A-S, Noureddine S, Delbosc B. Interstitial keratitis diagnosis and treatment. J Fr Ophtalmol. 2019;42(6):e229-e237. PMID: 31103357 pubmed.ncbi.nlm.nih.gov/31103357/.
Salmon JF. Cornea. In: Salmon JF, ed. Kanski's Clinical Ophthalmology. 9th ed. Philadelphia, PA: Elsevier; 2020:chap 7.
Vasaiwala RA, Bouchard CS. Noninfectious keratitis. In: Yanoff M, Duker JS, eds. Ophthalmology. 5th ed. Philadelphia, PA: Elsevier; 2019:chap 4.17.
World Health Organization website. Blindness and vision impairment. www.who.int/health-topics/blindness-and-vision-loss#tab=tab_1. Accessed September 23, 2020.