eMedicine Specialties > Ophthalmology > Cornea

Keratitis, Interstitial: Follow-up

Author: Parag A Majmudar, MD, Fellowship Co-Director, Department of Ophthalmology, Cornea and Refractive Surgery Service, Assistant Professor, Rush-Presbyterian-St Luke's Medical Center
Contributor Information and Disclosures

Updated: Dec 14, 2007

Follow-up

Further Outpatient Care

  • The topical steroid medications are tapered slowly, over weeks to months, depending on the clinical response.

Inpatient & Outpatient Medications

Complications

  • Complications related to IK generally are due to corneal thinning and perforation. Although these occur rarely, perforations of the cornea may be treated urgently with conventional penetrating keratoplasty surgical techniques.

Prognosis

  • With appropriate treatment, visual acuity in IK generally can be preserved. In case of permanent corneal scarring, surgical therapy often is successful provided that the underlying cause of inflammation is controlled.

Patient Education

Miscellaneous

Medicolegal Pitfalls

  • It is important to recognize that IK may develop in persons who have untreated syphilis. Practitioners should attempt to determine whether or not a patient has been treated appropriately in the past to prevent the development of neurosyphilis.
  • Another important association to keep in mind is that patients with Cogan syndrome are more likely to have a history of systemic vasculitides, and prompt referral to a rheumatologist may be critical.
 


More on Keratitis, Interstitial

Overview: Keratitis, Interstitial
Differential Diagnoses & Workup: Keratitis, Interstitial
Treatment & Medication: Keratitis, Interstitial
Follow-up: Keratitis, Interstitial
References
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References

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  2. Cogan DG, Dickersin GR. Nonsyphilitic interstitial keratitis with vestibuloauditory symptoms. A case with fatal aortitis. Arch Ophthalmol. Feb 1964;71:172-5. [Medline].

  3. Cogan DS. Syndrome of nonsyphilitic interstitial keratitis and vestibuloauditory symptoms. Arch Ophthalmol. 1945;33:144-9.

  4. Dekkers NW, Treskes M. Measles keratitis. Ophthalmol Clin North Am. 1994;74:574.

  5. Dinis da Gama R, Cidade M. Images in clinical medicine. Interstitial keratitis as the initial expression of syphilitic reactivation. N Engl J Med. Jun 6 2002;346(23):1799. [Medline].

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  7. Goegebuer A, Ajay L, Claerhout I, Kestelyn P. Results of penetrating keratoplasty in syphilitic interstitial keratitis. Bull Soc Belge Ophtalmol. 2003;(290):35-9. [Medline].

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  9. Jones BR, McGill JI, Steele AD. Recurrent suppurative kerato-uveitis with loss of eye due to infection by Acanthamoeba castellani. Trans Ophthalmol Soc U K. Jul 1975;95(2):210-3. [Medline].

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  15. Orsoni JG, Zavota L, Manzotti F, Gonzales S. Syphilitic interstitial keratitis: treatment with immunosuppressive drug combination therapy. Cornea. Jul 2004;23(5):530-2. [Medline].

  16. Pepose JS. Herpes simplex keratitis: role of viral infection versus immune response. Surv Ophthalmol. Mar-Apr 1991;35(5):345-52. [Medline].

  17. Rabb MF, Fine M. Penetrating keratoplasty in interstitial keratitis. Am J Ophthalmol. Jun 1969;67(6):907-17. [Medline].

  18. Roizenblatt J. Interstitial keratitis caused by American (mucocutaneous) leishmaniasis. Am J Ophthalmol. Feb 1979;87(2):175-9. [Medline].

  19. Tamesis RR, Foster CS. Ocular syphilis. Ophthalmology. Oct 1990;97(10):1281-7. [Medline].

  20. Taylor HR, Semba RD, Newland HS, Keyvan-Larijani E, White A, Dukuly Z, et al. Ivermectin treatment of patients with severe ocular onchocerciasis. Am J Trop Med Hyg. May 1989;40(5):494-500. [Medline].

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Further Reading

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Keywords

interstitial keratitis, IK, syphilitic keratitis, Cogan syndrome, syphilitic disease, syphilis, herpes

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Contributor Information and Disclosures

Author

Parag A Majmudar, MD, Fellowship Co-Director, Department of Ophthalmology, Cornea and Refractive Surgery Service, Assistant Professor, Rush-Presbyterian-St Luke's Medical Center
Parag A Majmudar, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Ophthalmology, American Society of Cataract and Refractive Surgery, International Society of Refractive Surgery, and Phi Beta Kappa
Disclosure: Nothing to disclose.

Medical Editor

Fernando H Murillo-Lopez, MD, Senior Surgeon, Unidad Privada de Oftalmologia CEMES
Fernando H Murillo-Lopez, MD is a member of the following medical societies: American Academy of Ophthalmology
Disclosure: Nothing to disclose.

Pharmacy Editor

Simon K Law, MD, PharmD, Assistant Professor of Ophthalmology, Jules Stein Eye Institute; Chief of Section of Ophthalmology Surgical Services, Department of Veterans Affairs Healthcare Center, West Los Angeles
Simon K Law, MD, PharmD is a member of the following medical societies: American Academy of Ophthalmology, American Glaucoma Society, and Association for Research in Vision and Ophthalmology
Disclosure: Nothing to disclose.

Managing Editor

Christopher J Rapuano, MD, Professor, Department of Ophthalmology, Jefferson Medical College; Co-Chairman of the Cornea Service, Co-Chairman of Refractive Surgery Department, Wills Eye Hospital
Christopher J Rapuano, MD is a member of the following medical societies: American Academy of Ophthalmology, Eye Bank Association of America, Pennsylvania Medical Society, and Philadelphia County Medical Society
Disclosure: Nothing to disclose.

CME Editor

Lance L Brown, OD, MD, Ophthalmologist, Affiliated With Freeman Hospital and St John's Hospital, Regional Eye Center, Joplin, Missouri
Disclosure: Nothing to disclose.

Chief Editor

Hampton Roy Sr, MD, Associate Clinical Professor, Department of Ophthalmology, University of Arkansas for Medical Sciences
Hampton Roy Sr, MD is a member of the following medical societies: American Academy of Ophthalmology, American College of Surgeons, and Pan-American Association of Ophthalmology
Disclosure: Nothing to disclose.

 
 
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