In an attempt to expand the knowledge of this condition of unknown etiology, we present 3 cases of linear interstitial keratitis. Case series (3 cases are presented) and literature review. [ncbi.nlm.nih.gov]

• Insect Bite

  Interstitial Keratitis is generally diagnosed using the following methods: Physical examination and medical history assessment: The medical history could include evaluating the following: Previous infections Medication use Insect bites Trauma to the eye [dovemed.com]

  History A comprehensive medical and ocular history including the previous history of herpetic infections, other previous infections, an exposure history to insect bites, animals, environment, a travel history to endemic regions of disease, sexually transmitted [eyewiki.aao.org]

• Corneal Opacity

  METHODS: Five eyes of five patients with congenital syphilitic interstitial keratitis who underwent keratoplasty for corneal opacities and corneal edema were studied. [ncbi.nlm.nih.gov]

  For the past few years, the parents noted increased corneal opacity. Examination revealed opacity of the anterior stroma with ghost vessels. This is thought to be interstitial keratitis secondary to herpertic keratitis. [sarawakeyecare.com]

  Some corneal opacity usually remains, causing mild to moderate vision impairment. Corneal opacification and other typical findings on slit-lamp examination Serologic testing to determine etiology The specific etiology must be determined. [msdmanuals.com]

• Foreign Body Sensation

  A 45-year-old woman with healed syphilitic interstitial keratitis presented with decreased vision, foreign-body sensation of the right eye, and bilateral conjunctival injection. [ncbi.nlm.nih.gov]

  Patients tend to be more symptomatic if the lesions are corneal and may present with tearing, irritation, photophobia or foreign body sensation. [clspectrum.com]

  Presentation - redness, pain, photophobia, foreign body sensation and reduced visual acuity. There will usually be an epithelial defect ± the presence of white cell infiltrate ± oedema. [patient.info]

• Conjunctival Injection

  A 45-year-old woman with healed syphilitic interstitial keratitis presented with decreased vision, foreign-body sensation of the right eye, and bilateral conjunctival injection. [ncbi.nlm.nih.gov]

  Ocular signs usually begin with sectoral conjunctival injection followed by subepithelial, peripheral keratitis. The interstitial keratitis which subsequently develops is described as anterior stromal or superficial. [eyewiki.aao.org]

  Patients may have an anterior chamber reaction, fine keratic precipitates and conjunctival injection. In the chronic phase, the vessels regress leaving remnants (ghost vessels). [clspectrum.com]

  Regarding the ocular surface, syphilis can cause conjunctivitis, 6 episcleritis or scleritis. 7,8 Interstitial keratitis (See Figure 1), often associated with conjunctival injection and anterior chamber inflammation, is a well-recognized manifestation [reviewofophthalmology.com]

The patient underwent a systemic workup for interstitial keratitis. All results including RPR and MHA-TP were negative except for Lyme antibody titer (enzyme-linked immunosorbent assay [ELISA]) 178 U/ml (normal, <159 U/ml). [ncbi.nlm.nih.gov]

• Borrelia Burgdorferi

  Lyme disease: The causative organism in Lyme disease is the spirochete Borrelia burgdorferi and typically is transmitted by the deer tick vector, Ixodes. [odlarmed.com]

   Lyme disease  Lyme disease is caused by infection with the spirochete Borrelia burgdorferi via the Ixodes scapularis deer tick 46.  Signs of disease have been separated into three stages  Stage 1 (Early localisied infection) Flulike illness and [slideshare.net]

Therefore, treatment of the corneal manifestations may often occur independently or in parallel to the treatment of its underlying systemic cause. [eyewiki.aao.org]

Treatment & Management Treatment of interstitial keratitis depends on the specific underlying disorder. [emedicine.medscape.com]

Treatment The treatment should include topical treatment for keratitis and systemic treatment for syphilis. 1. Local treatment. Topical corticosteroid drops e.g., dexamethasone 0.1% drops every 2-3 hours. [ophthalmologylife.blogspot.com]

Treatment • Urgent evaluation is indicated because early treatment prevents permanent deafness & blindness. • Systemic & topical corticosteroids. 18. Thank You [slideshare.net]

The prognosis of this secondary glaucoma was very poor, although medical therapy was taken for the wide open angle type, and surgical therapy for the angle closure type. [ncbi.nlm.nih.gov]

Prognosis The prognosis for interstitial keratitis is good if recognized and treated early before significant corneal scarring has occurred. [eyewiki.aao.org]

The prognosis with early diagnosis and treatment is good There are different types of keratitis, which include: Amoebic Keratitis: It is often seen in those who wear contact lenses and is caused by Acanthamoeba, a free-living amoeba Fungal Keratitis caused [dovemed.com]

Bacterial etiologies: Syphilis, Lyme Disease, Tuberculosis, Leprosy, Brucellosis, Leptospirosis Viral etiologies: Herpesviridae (Herpes simplex, Herpes Zoster, Epstein- Barr), HLTV-1, Mumps, Measles, Vaccinia, Variola Parasitic etiologies: Onchocerciasis [eyewiki.aao.org]

Linear interstitial keratitis is a rare clinical entity and its histopathologic etiology remains undetermined. [ncbi.nlm.nih.gov]

Corneal opacification and other typical findings on slit-lamp examination Serologic testing to determine etiology The specific etiology must be determined. [msdmanuals.com]

[…] sensorineural hearing loss Brain tumor (eg, meningioma) Ménière disease Infections Treponema pallidum HIV Vasculitis Microscopic polyangiitis Polyarteritis nodosa Granulomatosis with polyangiitis (GPA) Connective tissue diseases Rheumatoid arthritis Background Epidemiology [arupconsult.com]

Diagnosis: Cogan's Syndrome EPIDEMIOLOGY Predominantly young to middle aged adults Rare SIGNS Interstitial keratitis (limbal stromal opacity or edema, non-inflammed vascular loops in the mid-stroma) Other inflammation of the eye ( episcleritis, scleritis [webeye.ophth.uiowa.edu]

Epidemiology Interstitial keratitis is generally seen in the context of syphilis and, less commonly, in the context of herpes and Cogan syndrome. [emedicine.medscape.com]

Abstract We studied four patients with the clinical entity of nonsyphilitic interstitial keratitis and vestibuloauditory symptoms to determine whether immunologic abnormalities play a role in its pathophysiology. [ncbi.nlm.nih.gov]

A discussion of the causes, pathophysiology, and treatment of interstitial keratitis is also undertaken. The differential diagnosis and appropriate laboratory tests for patients with interstitial keratitis is given. [morancore.utah.edu]

Pathophysiology The pathophysiology of interstitial keratitis is unknown but varies significantly by etiology. [eyewiki.aao.org]

(GPA) Connective tissue diseases Rheumatoid arthritis Background Epidemiology Incidence – rare; ~250 cases reported (Singer, 2015) Age – young adults in 20s-30s A few cases in children and adults >50 years Sex – M:F, equal Ethnicity – none reported Pathophysiology [arupconsult.com]

SYSTEMIC - high doses of penicillin to prevent further development of lesions - systemic steroids can be given in refractory cases. 15. [slideshare.net]

Prevention Prevention consists of avoiding the infection that causes interstitial keratitis. If you do get infected, get prompt and thorough treatment and follow-up. Images References Ginsberg SP. Corneal problems in systemic disease. [ufhealth.org]

Special attention is given to the prevention and treatment of these diseases found in developing countries as well as the latest findings about new antimicrobial agents, gram-negative infections and their management, and recommendations for immunization [books.google.de]