If you have a painful red eye, increasing light sensitivity, blurred vision, or think you may have an eye infection, this page will help you understand what infectious keratitis is, why it can become serious quickly, how it is diagnosed, and what treatment options may be needed.
Infectious keratitis is an infection of the cornea and is considered a vision-threatening eye emergency.
What is infections keratitis, and why it affects vision.
Common symptoms and how they often begin.
Possible causes, risks, factors, behaviours.
How doctors confirm the diagnosis.
What treatment options are available?
What results can you expect after treatment.
Übersicht
Infektiöse Keratitis tritt auf, wenn Mikroorganismen - wie Bakterien, Pilze oder Viren - in das Hornhautgewebe eindringen. Die Erkrankung führt in der Regel zu Entzündungen, Geschwüren (einem Verlust von Hornhautgewebe) und einer Störung der natürlichen Schutzbarrieren des Auges.
Das Risiko ist höher bei Menschen, die Kontaktlinsen tragen, die bereits eine Augenoperation hinter sich haben, die ein Trauma am Auge erlitten haben oder bei denen bereits Oberflächenerkrankungen vorliegen, die den Tränenfilm oder das Hornhautepithel beeinträchtigen.
Symptome
Symptoms can escalate quickly. A corneal infection is not something to “watch for a few days.”
Vision may become less sharp because the infection affects the normally clear cornea.
Many patients develop marked sensitivity to light.
The eye often becomes red and inflamed, sometimes very suddenly.
In some cases, a pale or white spot can be seen on the clear surface of the eye.
Pain is one of the most important warning signs. Infectious keratitis is often much more painful than ordinary irritation or dryness.
Patients often describe a foreign-body sensation, tearing, or discharge, especially as the surface becomes more inflamed.
Ursachen
A healthy cornea has natural protective barriers. Infection becomes more likely when those barriers are disrupted. Contact lens wear is one of the most common risk factors, especially if lenses are overworn, cleaned improperly, or exposed to water. Trauma, scratches, previous eye surgery, and pre-existing ocular surface disease can also make infection more likely.
If you wear contact lenses and develop pain, redness, or blurred vision, remove the lens and seek urgent ophthalmic care.
The organism involved also depends on circumstances. Bacterial infections are common, particularly in contact lens wearers. Fungal keratitis is more often associated with trauma involving plant or organic material. Acanthamoeba keratitis is strongly associated with contact lens exposure to contaminated water. Viral keratitis, especially herpes simplex virus, follows a different pattern and may recur over time.
Infektiöse Keratitis kann durch verschiedene Arten von Mikroorganismen verursacht werden:
Jede Art von Erreger kann einen anderen Behandlungsansatz erfordern, und oft ist die genaue Ursache nicht sofort klar. Aus diesem Grund sind Labortests und klinisches Urteilsvermögen bei der Behandlung der Erkrankung entscheidend.
Diagnosis
Diagnosis starts with urgent specialist examination. The doctor looks at the cornea with a slit lamp, assesses how deep and extensive the infection appears, asks about contact lenses, trauma, surgery, water exposure, and current symptoms, and determines how urgently treatment needs to begin. Because corneal ulcer management should not wait for culture results, treatment is often started immediately when infection is suspected.
The doctor asks about pain, redness, blurred vision, contact lens use, trauma, recent surgery, and surface disease.
This helps assess the size, location, depth, and appearance of the corneal ulcer or infiltrate.
For some ulcers, especially more severe or atypical ones, the doctor may take a sample from the cornea for microscopy, culture, or other laboratory testing to identify the organism.
Treatment
Treatment depends on the cause, severity, and speed of progression. In many cases, treatment begins immediately and may require very frequent medicated drops, sometimes even around the clock at first.
In ausgewählten Fällen, in denen eine antimikrobielle Standardtherapie nicht ausreicht, PACK-CXL) (Photoaktiviertes Chromophor für Keratitis - Hornhautvernetzung) kann als ergänzende Behandlung eingesetzt werden.
Bei PACK-CXL wird Riboflavin (Vitamin B2) auf die infizierte Hornhaut aufgetragen und anschließend mit UV-A-Licht aktiviert. Dadurch werden reaktive Sauerstoffspezies erzeugt, die Krankheitserreger direkt schädigen und die Widerstandskraft der Hornhaut gegen enzymatischen Abbau erhöhen können. Die Behandlung ersetzt zwar keine antimikrobiellen Augentropfen, kann aber im Rahmen einer umfassenderen Behandlungsstrategie zur Eindämmung von Infektionen und zur Stabilisierung der Hornhaut beitragen.
Die Behandlung der infektiösen Keratitis ist aus mehreren Gründen komplex:
Da die Infektion häufig die strukturelle Integrität der Hornhaut beeinträchtigt, können zusätzliche Eingriffe erforderlich sein, um die Heilung zu unterstützen und Komplikationen zu verhindern.
Outcomes
Outcomes depend on how quickly treatment begins, what organism is responsible, how deep the infection is, whether the visual axis is involved, and whether the cornea develops scarring or thinning. Even with proper treatment, some infections leave a scar, and severe cases can permanently affect vision.
That said, urgent diagnosis and well-targeted treatment can make a major difference. For many patients, the main goals are to eliminate the infection, preserve the structure of the cornea, reduce the chance of scarring, and protect long-term vision as much as possible. This is an inference based on the treatment goals consistently described across patient and clinical guidance.
Warum wir?
At ELZA Instutute, we know that infectious keratitis is both urgent and complex. Treating it well means more than confirming that an infection is present. We assess how aggressive it is, which organism may be responsible, how quickly the cornea is changing, and whether standard antimicrobial therapy is likely to be enough.
Our advantage is that we combine specialist corneal expertise with advanced treatment options. We offer PACK-CXL for selected cases as an adjunctive therapy when standard treatment alone may not be sufficient.
ELZA has contributed significantly to the scientific understanding and clinical development of PACK-CXL. We also provide dedicated access for patients from abroad through our international-patient pathway and online consultations.
For our patients, that means care in a center that is used to managing difficult corneal disease, can act quickly, and can offer both established and advanced options to help preserve vision and support corneal healing.
FAQs
Yes. Corneal ulcers and infectious keratitis are considered vision-threatening conditions that require urgent treatment.
They can increase the risk substantially, especially if hygiene is poor, lenses are overworn, or they come into contact with water.
Yes. Even when the infection is treated correctly, corneal scarring can remain and may affect vision depending on location and severity.
Not always. Some infections are viral, fungal, or parasitic, and even bacterial infections may require culture-guided changes if the first treatment is not enough.
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