7 Common Keratitis Symptoms You Should Never Ignore

Keratitis is an inflammation of the cornea, the clear, dome-shaped tissue that covers the front of your eye. This condition can be caused by infections, injuries, or other factors, and it requires prompt medical attention to prevent serious complications, including vision loss. Understanding the symptoms of keratitis is crucial for early detection and treatment.

The cornea plays a vital role in focusing light as it enters the eye, making it essential for clear vision. When inflammation occurs, it can significantly affect your eyesight and cause considerable discomfort. Whether caused by bacteria, viruses, fungi, or parasites, keratitis can progress rapidly if left untreated. Recognizing the warning signs early can make a significant difference in treatment outcomes and help preserve your vision.

1. Eye Pain and Discomfort

One of the most prominent symptoms of keratitis is eye pain, which can range from mild discomfort to severe, sharp pain. This pain is often more intense than the irritation you might feel from simple eye strain or dry eyes.

The discomfort typically occurs because the cornea contains numerous nerve endings, making it one of the most sensitive tissues in the body. When inflammation affects these nerves, even minor movements like blinking can become painful. The pain may feel like:

• A sharp, stabbing sensation
• A persistent aching or burning feeling
• A foreign body sensation, as if something is stuck in your eye
• Increased sensitivity when moving your eye

The intensity of pain can vary depending on the severity and cause of the keratitis. Some people describe it as constant discomfort, while others experience waves of sharp pain, particularly when exposed to light or when blinking.

2. Eye Redness and Bloodshot Appearance

Redness is a hallmark symptom of keratitis, occurring as blood vessels in and around the eye become dilated in response to inflammation. The white part of your eye (sclera) may appear pink or red, and this discoloration is usually more pronounced around the cornea.

This redness differs from typical eye redness caused by fatigue or minor irritation. With keratitis, the redness tends to be:

• More intense and concentrated around the cornea
• Persistent and doesn’t improve with rest
• Often accompanied by other symptoms like pain or discharge
• Progressive, potentially worsening over time without treatment

The bloodshot appearance results from the body’s immune response to infection or injury, as it sends more blood to the affected area to fight off the problem and promote healing. However, this inflammation can actually worsen the condition if not properly managed with medical intervention.

3. Blurred or Decreased Vision

Vision changes are a serious symptom of keratitis that should never be ignored. The cornea’s primary function is to help focus light entering the eye, so any inflammation or damage to this structure can significantly impact visual clarity.

Patients with keratitis often experience:

• Gradual or sudden blurring of vision
• Difficulty focusing on objects at any distance
• Cloudy or hazy vision, as if looking through fog
• Reduced visual acuity that doesn’t improve with blinking

The severity of vision impairment depends on the location and extent of corneal involvement. If the inflammation affects the central cornea, vision problems will be more pronounced than if only the peripheral areas are involved. In severe cases, untreated keratitis can lead to corneal scarring, which may cause permanent vision loss. This is why any vision changes associated with eye pain or redness require immediate medical evaluation.

4. Excessive Tearing and Watery Eyes

Increased tear production is the eye’s natural defense mechanism against irritation and infection. With keratitis, the eyes often produce excessive tears in an attempt to flush out the irritant or pathogen causing the inflammation.

This symptom manifests as:

• Constantly watery eyes that require frequent wiping
• Tears streaming down the face, especially in bright light
• A feeling of wetness around the eyes throughout the day
• Clear or slightly cloudy discharge

While tearing is a protective response, excessive tearing can be uncomfortable and interfere with daily activities. The tears may also be accompanied by other forms of discharge, depending on the underlying cause of the keratitis. It’s important to note that while increased tearing might temporarily relieve some discomfort, it doesn’t treat the underlying condition, and medical intervention is still necessary.

5. Photophobia (Light Sensitivity)

Photophobia, or extreme sensitivity to light, is a common and often debilitating symptom of keratitis. Patients with this condition frequently find that exposure to light—whether from the sun, indoor lighting, or screens—causes significant discomfort and pain.

This light sensitivity occurs because inflammation of the cornea affects how light is processed by the eye. The symptoms include:

• Squinting or difficulty keeping eyes open in normal lighting
• Intense pain or discomfort when exposed to bright lights
• Preference for dimly lit or dark environments
• Headaches triggered by light exposure
• Need to wear sunglasses even indoors

The photophobia associated with keratitis can be so severe that it significantly impacts daily functioning, making it difficult to work, drive, or perform routine activities. This symptom often worsens as the condition progresses and typically improves only with appropriate treatment of the underlying keratitis.

6. Eye Discharge

Abnormal eye discharge is a telltale sign of infectious keratitis and can help healthcare providers determine the underlying cause of the inflammation. The type, color, and consistency of the discharge provide important diagnostic clues.

Eye discharge in keratitis may present as:

• Thick, yellow or green pus-like discharge (often indicating bacterial infection)
• White or stringy mucus
• Crusty buildup on eyelashes, especially after sleep
• Discharge that causes the eyelids to stick together

The discharge is a result of the body’s immune response to infection, containing white blood cells, dead tissue, and the infectious organisms themselves. Bacterial keratitis typically produces more purulent (pus-like) discharge, while viral or fungal infections may cause different types of discharge. Regardless of the type, any abnormal eye discharge combined with other symptoms of keratitis warrants immediate medical attention.

7. Foreign Body Sensation

Many people with keratitis report a persistent feeling that something is stuck in their eye, even when nothing is actually there. This sensation, known as a foreign body sensation, can be extremely uncomfortable and distracting.

This symptom is characterized by:

• A gritty or sandy feeling in the eye
• Sensation of an eyelash or particle lodged under the eyelid
• Urge to rub the eye constantly (which should be avoided)
• Discomfort that persists despite blinking or flushing the eye
• Feeling that worsens with eye movement

This sensation occurs because inflammation and damage to the corneal surface create irregularities that the eye perceives as foreign material. The cornea’s high concentration of nerve endings makes it extremely sensitive to even microscopic changes in its surface. While the instinct may be to rub the eye for relief, this can actually worsen the condition by causing additional trauma to the already inflamed cornea and potentially introducing more bacteria or irritants.

Main Causes of Keratitis

Understanding what causes keratitis can help in prevention and early recognition of the condition. The causes can be broadly categorized into infectious and non-infectious origins.

Infectious Causes

• Bacterial Keratitis: Often associated with contact lens wear, especially when lenses are worn overnight or not properly cleaned. Common bacteria include Staphylococcus aureus and Pseudomonas aeruginosa.
• Viral Keratitis: Most commonly caused by the herpes simplex virus (HSV) and varicella-zoster virus. These infections can recur and cause progressive corneal damage.
• Fungal Keratitis: Typically results from eye trauma involving organic matter like tree branches or plant material. More common in tropical and agricultural environments.
• Parasitic Keratitis: Most notably caused by Acanthamoeba, a microscopic organism found in water. This is particularly associated with swimming or showering while wearing contact lenses, or using contaminated lens solution.

Non-Infectious Causes

• Eye Injury: Scratches or trauma to the cornea from foreign objects, fingernails, or other sources can lead to keratitis.
• Contaminated Contact Lenses: Poor lens hygiene, using tap water to clean lenses, or wearing lenses beyond their recommended duration increases risk.
• Dry Eyes: Severe dry eye syndrome can compromise the cornea’s protective tear film, making it vulnerable to inflammation.
• Immunocompromised State: People with weakened immune systems are more susceptible to developing keratitis from organisms that wouldn’t normally cause problems.
• Contaminated Water Exposure: Swimming in contaminated water, hot tubs, or using contaminated water sources can introduce pathogens to the eye.

Prevention Strategies

While not all cases of keratitis can be prevented, following these guidelines can significantly reduce your risk of developing this serious eye condition.

Contact Lens Hygiene

• Always wash and dry your hands thoroughly before handling contact lenses
• Use only sterile contact lens solution—never tap water, saliva, or homemade solutions
• Replace contact lens cases every three months
• Never wear contact lenses longer than recommended
• Remove contact lenses before swimming, showering, or sleeping (unless specifically prescribed for overnight wear)
• Follow the cleaning and disinfection schedule prescribed by your eye care professional
• Discard disposable lenses according to the recommended schedule

Eye Protection

• Wear protective eyewear when working with tools, chemicals, or in dusty environments
• Use safety goggles during activities that could cause eye injury
• Avoid touching or rubbing your eyes with unwashed hands
• Be cautious around plants and tree branches that could scratch your eye

General Eye Care

• Maintain good overall eye hygiene
• Use lubricating eye drops if you have dry eyes
• Seek immediate treatment for any eye injury, no matter how minor it seems
• If you have herpes simplex virus, manage outbreaks promptly to prevent eye involvement
• Attend regular eye examinations with your optometrist or ophthalmologist
• Avoid sharing eye makeup, towels, or anything that touches the eyes

For Contact Lens Wearers

• Give your eyes regular breaks from contact lenses by wearing glasses periodically
• Never wear contact lenses if your eyes are red, irritated, or uncomfortable
• Keep backup glasses available
• Store lenses properly in fresh solution daily
• Rub and rinse lenses even when using “no-rub” solutions for optimal cleaning

Frequently Asked Questions

How quickly do keratitis symptoms develop?

Symptoms can develop rapidly, sometimes within 24 hours, especially with bacterial keratitis. Viral and fungal keratitis may develop more gradually over several days. Any sudden eye pain, redness, or vision changes should be evaluated immediately by an eye care professional.

Can keratitis go away on its own?

No, keratitis typically requires medical treatment and will not resolve on its own. Attempting to wait out the symptoms can lead to serious complications, including permanent vision loss. If you suspect keratitis, seek medical attention promptly.

Is keratitis contagious?

The keratitis itself is not contagious, but some of the viruses or bacteria that cause it can be transmitted to others. Practice good hygiene, avoid sharing personal items like towels or eye makeup, and wash your hands frequently if you have infectious keratitis.

How is keratitis different from conjunctivitis (pink eye)?

While both conditions cause eye redness, keratitis affects the cornea and is generally more serious than conjunctivitis, which affects the conjunctiva (the membrane covering the white of the eye). Keratitis typically causes more severe pain, significant light sensitivity, and greater risk of vision loss compared to conjunctivitis.

Who is at highest risk for developing keratitis?

Contact lens wearers, especially those who wear lenses overnight or don’t follow proper hygiene practices, are at highest risk. Others at increased risk include people with weakened immune systems, those with a history of eye trauma or surgery, individuals with chronic dry eyes, and people who have had previous herpes simplex infections.

Can I wear contact lenses if I’ve had keratitis?

After recovery from keratitis, you may be able to resume wearing contact lenses, but this depends on the severity of the infection and your eye doctor’s recommendation. You’ll need complete healing and clearance from your ophthalmologist before returning to contact lens wear. Some cases may result in scarring that makes contact lens wear difficult or inadvisable.

How long does it take to recover from keratitis?

Recovery time varies depending on the cause and severity. Mild bacterial keratitis may improve within a few days with proper treatment, while more severe cases or fungal/parasitic keratitis can take weeks to months to heal completely. Following your treatment plan carefully is essential for optimal recovery.

Can keratitis cause permanent damage?

Yes, if left untreated or if treatment is delayed, keratitis can cause permanent corneal scarring, leading to lasting vision impairment or blindness. This is why recognizing symptoms early and seeking immediate medical attention is so important. Even with treatment, severe cases may result in some permanent changes to the cornea.

References:

• Mayo Clinic – Keratitis
• American Academy of Ophthalmology – Keratitis
• National Eye Institute – Corneal Conditions
• Centers for Disease Control and Prevention – Keratitis
• MedlinePlus – Corneal Ulcers and Infections