Any corneal inflammation is known as keratitis. The concept is derived from the Greek word "κέρας- (kerat)" which means "horn" and "itis", which is the classic proverb in inflammatory medicine. Keratitis is a common clinical condition Proper initial diagnosis and treatment are crucial in limiting the residual lesions and scars left on the cornea, as maintaining its transparent property is most important in restoring and maintaining beneficial vision in every patient affected.
Causes of Keratitis
The cornea is sometimes targeted at one direct pathophysiological state, others – the compromise is secondary to an external indirect event in the complex functional anatomical triad between the lids, cornea and tear film.
Types of keratitis
There are many different causes of keratitis that can be grouped into three main groups, including infectious, autoimmune / inflammatory, neoplastic and traumatic causes.
1. Infectious keratitis
As an important component of the anatomical anterior wall of the eye, the cornea is a structure highly exposed and vulnerable toexternal pathogens.Any destruction of the corneal epithelium, as observed occasionally in dry eye syndrome, severe blepharitis, and injuries is cause distortion of the epithelial barrier, as seen in corneal scars, after surgical procedures or horny foreign bodies, which may predispose to corneal infections. Sometimes this is the result of highly pathogenic high affinity microorganisms. to epithelial cells, those that can cause direct involvement, as is commonly observed in the herpes virus family.
2. Inflammatory – Autoimmune keratitis (Non-purulent keratitis)
Any condition that may cause the corneal inflammatory response can be classified in this group of causes of keratitis.
3. Neoplasia associated with inflammatory involvement of the cornea
Any neoplastic process in the limbic area and the surrounding conjunctiva can indirectly spread to the cornea and cause an inflammatory reaction, this is usually not considered in the differential diagnosis of keratitis and is perhaps the rarest and least suspected cause of inflammation of the cornea and limbs ..
4. Traumatic keratitis
In this group, we may consider trauma from direct blunt injury with secondary corneal abrasion and corneal edema or surgical injury that damages the endothelial layer causing secondary corneal edema and endothelial insufficiency with concomitant bull keratopathy. The type of keratitis observed in these situations is mainly endothelial and stromal with multiple ten-folds, disorganization of stromal collagen fibers, keratic precipitates, and often a related anterior chamber reaction.
A clear history of trauma may not be obvious, and clinicians are encouraged to obtain it from clinical history, remembering that sometimes a traumatic event may precede the clinical manifestation for many years (i.e., previous cataract surgery, etc.) .n.)
Keratitis treatmentwill depend on the direct cause; for this reason, proper diagnosis is crucial at the time of decision on initial treatment.
1. Infectious causes
In cases of viral herpetic keratitis, the drug is optionally aciclovir in topical or oral form depending on the spread of keratitis in the stratum corneum. In resistant cases, the alternative treatment will be topical trifluorothymidine 1% (F3T) or vidarabine 3% (Vira-Atm). If high intraocular pressure (IOP) is detected, this should also be treated with lowering IOP. Other antiviral agents such as local ganciclovir 0.15% (Zirgantm) have become more widely used in recent years.
2. Inflammatory / autoimmune
Systemic therapy is usually required for this type of keratitis; the important treatment approach is to identifyischemia of the corneal mucosa and / or melting of the cornea. Severe cases will require a high dose of oral steroids and immunosuppressants. There are no autoimmune cases presenting inflammatory characteristics due to blepharitis and / or dry eyes with marginal infiltrates do not benefit from topical steroids, but it is also very important to treat the original cause of keratitis, as this is usually secondary. ie removal of calculi and ectopic eyelashes, repair laphthalmosis or other eyelid malposition, treat dry eyes with local lubricants, etc.
Surgical removal and biopsy are important as they are based on the histological diagnosis that additional interventions such as cryotherapy or radiation therapy can be indicated and planned. The excision of any suspected lesion should ideally have a stock of 2 cm healthy tissue. to prevent relapses.
In cases of corneal abrasion, the optional treatment is to use topical antibiotic ointments to prevent infections and to coat the eye for 24 hours to allow corneal epithelialization, with the use of preservatives free. without cycloplegic drops initially to relieve the pain before it is reduced.
In case of blunt injuries, the use of topical anti-inflammatory or steroidal drops is useful depending on the severity of the inflammation. In the case of bull keratopathy, corneal endothelial transplantation is very successful, the use of highly osmotic drops such as NACL 5% or dressing lenses can sometimes clear the corneal stroma and relieve pain while waiting for a corneal donor.
Keratitis treatment with Ayurveda medicine
Every eye disease is a big burden for ophthalmologists and patients, as well as in modern practice. The age associated with senile cataract is another major burden in the public health system. There are no effective solutions to these problems in modern medicine today. Laser and invasive rooms are more expensive and beyond the reach of people, which again has many limitations and side effects. Ophthalmologists are still looking for effective solutions to these acute and life-threatening diseases.
In contrast, Ayurveda has a rich tradition in the treatment of ocular diseases through holistic treatment such as Panchakarma and Kriyalpa (Ayurveda Eye Therapists) procedures. These are unique methods for non-invasive and non-surgical eye treatments that heal as well as prevention of diseases by improving vision and correcting the underlying pathological process.
Astang Ayurveda, Bhubaneswar, Odisha, IndiaProvide a complete Ayurveda eye care solution through Panchakarta, Kriyalpa (tarpana, Putavitsa, Anyana, Ascitana, Pindi and Vidalaka), eye health diet, individualized individual medicine and individual medicine exercises. Patient education for eye health is another integral part of the Ayurveda treatment protocol.