Corneal Inflammation: Symptoms, Diagnosis, and Treatment Options - Ophthalmology

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Corneal inflammation, often associated with conditions like viral conjunctivitis and keratitis, can lead to significant discomfort and visual impairment. Your symptoms of redness, swelling, photophobia (light sensitivity), and foreign body sensation are indicative of such inflammation. The fact that you experienced these symptoms after wearing contact lenses that had been improperly stored raises concerns about potential infections, including viral or parasitic infections.


Symptoms of Corneal Inflammation
Common symptoms of corneal inflammation include:
- Redness of the eye
- Swelling of the conjunctiva (the membrane covering the white part of the eye)
- Photophobia
- Blurred vision
- Foreign body sensation
- Tearing or dryness
In your case, the diagnosis of viral conjunctivitis and keratitis suggests that the inflammation is likely due to a viral infection, which can be exacerbated by the use of contaminated contact lenses.


Diagnosis
Diagnosis typically involves a thorough eye examination, including:
- Visual acuity tests
- Slit-lamp examination to assess the cornea and conjunctiva
- Fluorescein staining to identify corneal abrasions or ulcers
- Cultures or PCR tests to identify specific pathogens if a microbial infection is suspected.

In some cases, if the diagnosis remains unclear or if there is a suspicion of a more severe infection (like a microsporidian infection), further diagnostic procedures may be warranted.


Treatment Options
Treatment for corneal inflammation depends on the underlying cause:
1. Viral Infections: Antiviral medications may be prescribed if a viral infection is confirmed. Supportive care, including lubricating eye drops and cold compresses, can help alleviate symptoms.

2. Bacterial Infections: Antibiotic eye drops are typically used if a bacterial infection is suspected.

3. Parasitic Infections: If a microsporidian infection is confirmed, specific antifungal or antiparasitic treatments may be necessary. The use of medications like "Systane" (which you mentioned) may not be effective against such infections if they are primarily targeting bacteria.


Surgical Intervention
Regarding your questions about surgery:
1. Corneal Scraping: This procedure is sometimes necessary to obtain samples for culture and to confirm the presence of specific pathogens. It can also help in cases where there are corneal ulcers or significant damage.

2. Need for Surgery: If your condition does not improve with medical treatment and there is a confirmed diagnosis of a microsporidian infection, surgical intervention may be required. This could involve scraping the cornea or other procedures to remove infected tissue.

3. Vision Recovery: The prognosis for vision recovery after corneal inflammation largely depends on the extent of the damage to the cornea. If the inflammation is controlled and there is no significant scarring, many patients can regain their previous level of vision. However, persistent symptoms or complications may lead to long-term visual impairment.


Conclusion
It's crucial to follow up closely with your eye care provider, especially given the persistence of your symptoms and the potential for complications. If your condition does not improve or worsens, further evaluation and possibly a referral to a corneal specialist may be necessary. Maintaining good hygiene with contact lenses and seeking prompt treatment for any eye symptoms can help prevent such issues in the future.