What should I do if my child has keratitis?

In life, eye diseases are quite common, especially myopia and hyperopia, which have a relatively high incidence rate. Some teenagers wear glasses at a very young age, which means they will never be able to take them off for the rest of their lives. In addition to these two common eye diseases, diseases including keratitis are also relatively common. So what should parents do once their children are diagnosed with keratitis?

Keratitis is divided into two categories: ulcerative keratitis, also known as corneal ulcer, and non-ulcerative keratitis, also known as deep keratitis. It is caused by different internal and external factors. Inflammation caused by corneal trauma, bacteria and viruses invading the cornea. The affected eye may feel a foreign body sensation, stinging or even burning. There is mixed congestion on the surface of the conjunctiva, accompanied by symptoms such as photophobia, tearing, visual impairment and increased secretions. The corneal surface is infiltrated and ulcers are formed. Ulcerative keratitis, also known as corneal ulcer, is mostly caused by exogenous factors, that is, infectious pathogens invade the corneal epithelial cell layer from the outside and cause inflammation.

Treatment: The basic principle of treating corneal ulcer is to take all effective measures to quickly control the infection, strive for early cure, and minimize the sequelae of keratitis. Since most ulcerative keratitis is caused by external factors, it is extremely important to eliminate the external factors and pathogenic microorganisms. To help diagnose the cause, a smear should be taken from the progressive edge of the corneal ulcer for bacterial culture and drug sensitivity testing (fungal culture if necessary). But do not delay treatment while waiting for test results; take necessary measures immediately.

The treatment process, precautions and application methods are described as follows:

1. Hot compress can dilate blood vessels in the eyes, relieve congestion, promote blood flow, enhance resistance and nutrition, and quickly recover from ulcers.

2. Flushing: If there is a lot of secretions, you can use normal saline or 3% boric acid solution to flush the conjunctival sac 3 times or more a day to flush out the secretions, necrotic tissue, bacteria and toxins produced by bacteria. In this way, not only the factors that spread the infection are reduced, but also the concentration of the local medicine is ensured not to decrease.

3. Mydriasis

a. Atropine is the main and commonly used drug, with a concentration of 0.25-2% solution or ointment, which is dripped or applied 1-2 times a day (be sure to press the lacrimal sac after dripping the medicine to prevent the solution from being excessively absorbed by the mucous membrane and causing poisoning).

b. It is not necessary for simple corneal ulcers or those with mild irritation symptoms, but it must be used for ulcers with significant irritation symptoms and those that are about to perforate. This drug has a dual effect in treating corneal ulcers; on the one hand, it allows the pupillary sphincter and ciliary muscles to rest, and on the other hand, it can prevent and treat iridocyclitis and its consequences. Furthermore, since the intraocular muscle spasms are relieved, it also has a relieving and analgesic effect.

4. Antibacterial agent

a. Sulfonamide chemicals such as 10-30% sodium sulfacetamide and 4% sulfisoxazole eye drops.

b. For Gram-positive coccal infections, topical application of 0.1% rifampicin eye drops, 0.5% erythromycin, or 0.5% bacitracin eye drops 4 to 6 times a day is sufficient to control the infection. Some broad-spectrum antibiotics such as 0.5% chloramphenicol, 0.25% chloramphenicol and 0.5% tetracycline (0.5%) are more effective in antibacterial effects.

c. For infections caused by Gram-negative bacteria, you can choose 1-5% streptomycin, 0.3-0.5% gentamicin, polymyxin B (20,000 units/ml), 0.25-0.5% neomycin, 0.5% kanamycin, etc.