Keratitis Self-Care: What to Do First and When to Seek Eye Care

Start with the safest first steps

Suspected keratitis needs prompt eye evaluation, not self-care alone. If you wear contact lenses and have pain, redness, blurry vision, or other signs of an eye infection, remove the lenses immediately and contact an eye doctor as soon as possible. Keeping a symptomatic lens in often worsens a contact-lens-related infection.

Do not wait for the eye to settle before arranging care. If you think you may have keratitis, see a healthcare provider immediately.

Take these protective steps:

• Do not swim while wearing contact lenses.
• Wash your hands before handling lenses.
• Use fresh disinfecting solution when cleaning and storing lenses.
• Do not reuse old solution or top off the solution already in a case.
• Rinse and store lenses in store-bought solution, not homemade saline, which can contain germs that may cause blindness.

They do not determine whether inflammation or infection is present.

Contact lenses should not be rinsed with or stored in tap water or sterile water. Sleeping with contact lenses is generally not advisable, even when the lenses are prescribed for extended wear.

Acanthamoeba keratitis is one reason water exposure matters for contact lens wearers. More than 23,000 people are estimated to be diagnosed with Acanthamoeba keratitis globally each year, so remove lenses before swimming, showering, or using a hot tub and seek care for symptoms after exposure.

Understand what keratitis means

Keratitis is inflammation of the cornea, the clear, dome-shaped tissue at the front of your eye that covers the pupil and iris. Keratitis may or may not involve an infection, so similar symptoms can have different causes.

Untreated or severe keratitis can permanently damage vision. With prompt attention, mild to moderate cases can usually be effectively treated without loss of vision. That difference is why redness, pain, or other symptoms deserve an eye evaluation rather than prolonged home treatment.

Bacterial keratitis may require antibiotic drops around four times a day and at night or as often as every 30 minutes, depending on severity. The frequency describes how often the prescribed drops may be needed, including overnight use in more serious cases; it is not a schedule to start without an examination.

Look for the likely causes and exposures

Keratitis can be infectious or noninfectious. Infectious causes include bacteria, viruses, fungi, and parasites. Noninfectious causes include an eye injury, wearing contact lenses too long, or a foreign body in the eye.

Contact lens use raises the risk of keratitis, especially with poor cleaning, wearing lenses longer than recommended, or sleeping in them. A scratched or otherwise damaged cornea can also make it easier for microorganisms to enter.

Contact lens-related infections of the cornea are called microbial keratitis and can cause serious health problems.

Sleeping in contact lenses carries a measurable infection risk. In a United States report, sleeping in lenses increased the risk for contact-lens-related eye infections six- to eightfold, and approximately one third of contact lens wearers reported sleeping or napping in their lenses.

The same report described contact lenses as a safe and effective form of vision correction when worn and cared for properly, and estimated that 45 million Americans used them. Proper use lowers risk, but it does not make new pain, redness, or blurred vision something to ignore.

Water exposure while wearing contact lenses, including swimming, showering, or using a hot tub, may increase the risk of Acanthamoeba keratitis. Water can expose the eye to organisms, including Acanthamoeba, that may cause infection.

Fungal keratitis is less common but serious and is often linked to an eye injury involving plant material or a weakened immune system. Tell the clinician about plant-related injuries, water exposure, and contact lens use because each detail can help identify the cause. Acanthamoeba keratitis can be difficult to diagnose early because it is relatively uncommon. Some contact lens users who practice proper hygiene can still develop an Acanthamoeba infection.

Herpes simplex virus commonly causes viral keratitis, which can recur and cause progressive damage. Certain autoimmune conditions can raise the risk because the immune system can attack the cornea; examples include systemic lupus erythematosus, Sjogren’s syndrome, rheumatoid arthritis, Wegener’s granulomatosis, and polyarteritis nodosa.

Severe dry eye and incomplete eyelid closure can also lead to keratitis because insufficient tears can injure and inflame the cornea. Mention these health conditions and ongoing eye problems during your examination. Keratitis usually affects only one eye when caused by an injury or infection such as herpes simplex virus, while both eyes may be affected when it is due to other causes.

Trauma to the cornea, including a large corneal abrasion, can lead to keratitis. UV light reflected by sand, water, ice, or snow can also cause keratitis. Appropriate eyewear is a good idea during activities that put you at risk for eye injuries or UV light exposure.

Keratitis affects more than contact lens wearers. In the United States, an estimated 1 million outpatient and emergency department visits for keratitis of all types were reported in 2010. Over an 11-year period, 1,075 contact lens-related corneal infections were reported to the FDA’s MedWatch database.

Those figures describe reported visits and reports, not your personal risk. Your symptoms, exposures, and examination findings matter more than a general estimate.

Recognize the symptoms that matter

Keratitis can cause eye pain, redness, watery discharge, a gritty or sandy feeling, blurred or decreased vision, light sensitivity, difficulty opening the eye, and swollen eyelids. You may have only some of these symptoms, and their intensity can vary.

Pay particular attention to changes in vision, increasing pain, and discomfort in bright light. Those symptoms can signal corneal involvement and should not be managed by continuing to wear a contact lens.

Severe keratitis can affect vision before treatment begins. About 41 percent of patients with severe keratitis had very poor vision when they first sought treatment; the 41 percent figure measures patients with severe disease at their first treatment visit, not all people with keratitis.

Arrange the prompt evaluation described in the warning-sign section, especially when vision changes or pain are present.

Know what an eye examination may include

An eye clinician may use a penlight, fluorescein staining, and a slit-lamp examination to assess the cornea and the extent of keratitis.

A slit lamp is a special instrument that provides bright light and magnification. It helps the clinician examine the character and extent of keratitis and check how it affects other eye structures.

Laboratory testing may be needed when the cause is unclear or infection is a concern. An eye-care provider may collect tears or some corneal cells for analysis to help determine the cause and develop a treatment plan. The clinician decides whether sampling is needed after examining the eye.

When you arrange an examination, mention contact lens use, sleeping in lenses, swimming, showering or hot-tub exposure, plant-related injury, recent trauma, dry eye, and autoimmune conditions. Also mention whether symptoms began in one eye or both, whether vision changed, and whether discharge or light sensitivity occurred. These details matter because keratitis has infectious and noninfectious causes. The examination may feel uncomfortable if opening the eye is painful, but the findings guide treatment.

Match treatment to the cause

Treatment for keratitis depends on its cause. A medicine that helps one type may not treat another type, so do not choose or stop prescription eye medicine based only on a symptom description.

The treatment plan also depends on the severity of the corneal problem. An eye examination helps determine which approach fits the findings.

Bacterial keratitis is primarily treated with antibiotic eye drops. Depending on severity, an oral antibiotic may be prescribed along with antibiotic ointment or eye drops.

Fungal keratitis typically requires antifungal eye drops and oral antifungal medication. Viral keratitis may be treated with antiviral medication or supportive care, depending on the virus. Herpes simplex or herpes zoster keratitis is treated with antiviral eye drops, an antiviral oral medication, or both. Other viral causes may need supportive care such as artificial tears. The medicine selected depends on the cause and the examination findings.

Acanthamoeba keratitis is treated with antiparasitic eye drops. Some infections resist medication and require treatment for several months, and severe cases may require a corneal transplant.

This type of infection can be difficult to identify from symptoms alone. Tell the clinician about contact lens use and any swimming, showering, or hot-tub exposure.

Noninfectious keratitis is treated according to severity. Artificial tears may be enough for mild discomfort from a corneal scratch, while significant tearing and pain may require topical eye medications.

Do not assume that a scratch, dry eye, or foreign-body sensation is harmless without an examination when pain, redness, blurred vision, or light sensitivity is present. Artificial tears for lubrication usually are effective for keratitis related to ocular dryness. Keratitis caused by an autoimmune disease is often treated with topical corticosteroid eye drops. Treating the underlying disease helps the keratitis heal with less chance of recurrence.

Corneal scratches or other injuries may not require treatment. An eye doctor may prescribe pain medication for significant pain, an antibiotic to speed healing, or an eye patch to protect the eye during healing.

Set expectations for recovery and care

Recovery from keratitis varies with the cause and severity. You will probably start feeling better after one or two days if you are taking anti-infective medication, but more severe cases take longer.

Mild bacterial keratitis caught early typically resolves within one to two weeks. People with mild bacterial keratitis should continue using prescribed medication for the full treatment duration, even after symptoms improve. The one- to two-week timeframe describes mild bacterial cases caught early; it does not apply to every form of keratitis. Keratitis caused by a virus or bacterium tends to improve relatively quickly. Keratitis caused by other viruses usually improves on its own within a few days.

The length of treatment and follow-up depends on the cause, severity, and how deeply inflammation affects the cornea.

Severe or delayed keratitis may require months of treatment and monitoring. Scarring or persistent inflammation can extend recovery, which is another reason to seek care promptly rather than waiting for symptoms to become severe. Recovery also depends on how quickly treatment begins and how deeply inflammation reaches the corneal tissue. With early treatment, most people with herpes simplex, shingles, or bacterial keratitis heal without loss of vision, but parasitic and fungal keratitis require early treatment and infection may persist despite appropriate treatment. Care costs can vary with the cause, severity, timing, testing, medication intensity, follow-up, and procedures. Available cost studies from China and Thailand do not establish typical U.S. patient charges or insurance coverage. Keratitis scarring can cause lasting vision impairment. In severe cases, corneal transplant surgery can sometimes restore vision.

Seek immediate eye care when warning signs appear

Get immediate medical attention for any of these warning signs:

• Severe eye pain
• Vision loss
• Redness with concerning symptoms
• Light sensitivity
• Discharge from the eye

These signs can indicate an eye emergency. Seek medical attention immediately for eye pain, swelling or watery eyes.

Choose the next step for your eye

Keratitis symptoms call for prompt professional assessment because treatment depends on the cause and untreated or severe disease can permanently damage vision. A qualified eye-care professional needs to decide which treatment fits your eye after an examination.

Questions to ask before managing keratitis at home

How long does keratitis usually take to heal?

Recovery varies with the cause, severity, and how quickly treatment begins. You may start feeling better after one or two days of anti-infective medication, while mild bacterial keratitis caught early typically resolves within one to two weeks. Severe or delayed cases may need months of treatment and monitoring, especially when scarring or persistent inflammation occurs.

Can keratitis heal on its own without treatment?

Some mild, noninfectious cases may improve with rest and eye care, and some viral cases may improve within a few days. However, infectious keratitis usually requires medical treatment, and symptoms cannot reliably show which type you have. Arrange prompt eye evaluation rather than waiting to see whether pain, redness, or blurred vision improves.

What happens if keratitis is not treated promptly?

Untreated or severe keratitis can permanently damage vision and may cause corneal scarring. Severe cases can require a corneal transplant, while Acanthamoeba infections may lead to severe vision loss if untreated. Prompt evaluation helps identify the cause and start appropriate treatment before inflammation or infection causes more lasting damage.