Inflammation affecting both the cornea and the conjunctiva of the eye

What is Keratoconjunctivitis?

Keratoconjunctivitis is a condition that involves inflammation of both the cornea (the clear, front part of the eye) and the conjunctiva (the thin membrane covering the white part of the eye and inside of the eyelids). It can be caused by infections, allergies, environmental irritants, or autoimmune conditions.

Depending on the cause, keratoconjunctivitis can range from a mild irritation to a more serious condition that affects vision. It often presents with redness, tearing, pain, and sensitivity to light.

What causes Keratoconjunctivitis?

Keratoconjunctivitis can be triggered by a number of different factors, including:

Infectious causes:

• Viral infections (e.g., Adenovirus) – most common cause of epidemic keratoconjunctivitis
• Bacterial infections (e.g., Staphylococcus, Streptococcus)
• Chlamydial infections (e.g., trachoma)

Allergic causes:

• Seasonal allergies (pollen, dust, pet dander)
• Atopic keratoconjunctivitis (chronic allergy-related inflammation)
• Giant papillary conjunctivitis (often due to contact lens irritation)

Other causes:

• Dry eye syndrome (keratoconjunctivitis sicca)
• Chemical exposure (e.g., chlorine, fumes)
• Autoimmune diseases (e.g., Sjögren’s syndrome)

Who is at risk?

• People with seasonal or chronic allergies
• Individuals who wear contact lenses
• Those with viral respiratory infections
• Patients with autoimmune conditions (like Sjögren’s or lupus)
• Individuals frequently exposed to environmental irritants
• People with poor hygiene practices related to eye care

What are the symptoms of Keratoconjunctivitis?

• Red or bloodshot eyes
• Eye pain or discomfort
• Itching or burning sensation
• Excessive tearing or watery eyes
• Blurred vision
• Sensitivity to light (photophobia)
• Swollen eyelids
• Mucus or pus-like discharge (especially in bacterial types)
• Gritty or sandy feeling in the eye

Symptoms usually affect both eyes, but sometimes start in one.

How is Keratoconjunctivitis diagnosed?

Diagnosis is made based on:

• Medical history and symptom review
• Eye examination using a slit-lamp
• Fluorescein dye test to detect corneal damage
• Tear production tests (in dry eye cases)
• Swabs or cultures from the eye to identify infectious agents
• Allergy testing if an allergic cause is suspected

How is Keratoconjunctivitis treated?

Treatment depends on the underlying cause:

For viral keratoconjunctivitis:

• Usually self-limiting, resolves in 1–3 weeks
• Cold compresses and lubricating eye drops to relieve discomfort
• Antiviral medications in severe or herpes-related cases
• Avoidance of contact lenses until healed

For bacterial keratoconjunctivitis:

• Antibiotic eye drops or ointments
• Warm compresses to ease swelling and drainage

For allergic keratoconjunctivitis:

• Antihistamine or mast-cell stabilizing eye drops
• Oral antihistamines for systemic symptoms
• Avoidance of allergens
• Cool compresses to relieve itching

For dry eye (keratoconjunctivitis sicca):

• Artificial tears or lubricating gels
• Punctal plugs to reduce tear drainage
• Omega-3 supplements
• Treat underlying autoimmune causes

What is the prognosis for Keratoconjunctivitis?

• Most cases are mild and resolve with appropriate treatment
• Viral forms may be contagious and can last longer
• Chronic or severe cases (like atopic or autoimmune-related types) may need long-term management
• Without treatment, complications like corneal ulcers or vision impairment can occur

Can Keratoconjunctivitis be prevented?

Yes, in many cases:

• Practice good eye hygiene
• Avoid rubbing your eyes, especially with unwashed hands
• Wash hands frequently to prevent spread of viral or bacterial infections
• Limit contact lens wear if symptoms develop
• Use protective eyewear in dusty or chemical-prone environments
• Avoid known allergens and keep indoor air clean
• Treat underlying conditions, like dry eye or autoimmune disorders, early