Interstitial keratitis is an inflammatory condition of the corneal stroma requiring active treatment to suppress local inflammation and preserve vision. Management is directed at controlling corneal inflammation, relieving ocular pain, and preventing the development of corneal neovascularization.
The clinical targets are control of local corneal inflammation, relief of ocular pain, and absence of corneal neovascularization on clinical examination.
The mainstay of therapy centres on a topical anti-inflammatory agent applied directly to the cornea and eye. The full protocol — including sequencing, tapering criteria, and situation-specific considerations — is set out in detail via the link below.
Dosages, frequencies, and the complete regimen are available in the full structured protocol.
Topical corticosteroids are the mainstay of therapy for the most common forms of interstitial keratitis and are effective both for alleviating acute symptoms of pain, discomfort and blurred vision and for reducing scarring and neovascularization.
They are the primary therapy for syphilitic interstitial keratitis, most immune forms of interstitial keratitis, and are used either in conjunction with antivirals (Herpes Simplex, Herpes Zoster) or alone in the viral-mediated interstitial keratitis.
The primary goals in the treatment of interstitial keratitis are to control local inflammation to prevent pain and visually significant scarring and to identify an underlying cause to reduce systemic sequelae of the disease.
Patients treated for interstitial keratitis should have their corticosteroids reduced to the lowest effective dosage based on a lack of active inflammation or neovascularization on clinical examination.
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