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Ceratite

  • Overview
  • Theory
  • Diagnosis
  • Management
  • Follow up
  • Resources
Last reviewed: 18 Aug 2025
Last updated: 22 Nov 2024

Summary

Definition

History and exam

Key diagnostic factors

  • presença de fatores de risco
  • infiltrado corneano
  • úlcera de córnea
  • lesão epitelial dendrítica ou geográfica
  • lesões cutâneas perioculares
  • úlcera multifocal da córnea com bordas hifadas
  • perineurite da córnea
  • ceratite intersticial
Full details

Other diagnostic factors

  • vermelhidão
  • dor
  • lacrimejamento elevado
  • edema da pálpebra
  • secreção
  • acuidade visual reduzida
  • fotofobia
  • pressão intraocular alta
  • história de infecção por vírus do herpes simples ou vírus da varicela-zóster
  • múltiplas cicatrizes estromais antigas
  • transiluminação da íris
  • hipoestesia da córnea
Full details

Risk factors

  • uso de lentes de contato
  • trauma corneano
  • erosão/abrasão da córnea
  • erosões recorrentes da córnea
  • imunocomprometimento
  • história de doença autoimune
  • triquíase
  • blefarite
  • olho seco
  • função deficiente da pálpebra
  • doença herpética prévia
  • ceratite por exposição
  • exposição a água contaminada
  • uso de corticosteroides tópicos
  • uso de anestesia tópica
  • cirurgia prévia do olho
Full details

Diagnostic investigations

1st investigations to order

  • raspagem da córnea: microscopia de lâmina
  • raspagem da córnea: culturas e sensibilidade
Full details

Investigations to consider

  • Hemograma completo
  • teste de HIV
  • testes para doenças autoimunes
  • raspagem da córnea: teste de reação em cadeia da polimerase
Full details

Treatment algorithm

INITIAL

bacteriana (presumida): alto risco

ACUTE

bacteriana

herpética

fúngica

por protozoário (Acanthamoeba)

ceratite não infecciosa

ONGOING

infecção herpética recorrente

visão prejudicada por cicatrização da córnea

Contributors

Authors

Kraig S. Bower, MD

Director of Refractive Surgery

The Wilmer Eye Institute

The Johns Hopkins Hospital

Baltimore

MD

Disclosures

KSB declares that he has no competing interests.

Frank S. Hwang, MD

Assistant Professor

Cornea, External Disease and Refractive Surgery

Loma Linda University Eye Institute

Loma Linda University

Loma Linda

CA

Disclosures

FSH declares that he has no competing interests.

Acknowledgements

Dr Kraig S. Bower and Dr Frank S. Hwang would like to gratefully acknowledge Dr Julie Freidlin Leigh, a previous contributor to this topic.

Disclosures

JFL declares that she has no competing interests.

Peer reviewers

Matilda Chan, MD, PhD

Proctor Fellow in Cornea and External Disease

Francis I. Proctor Foundation

University of California

San Francisco

CA

Disclosures

MC declares that she has no competing interests.

Parwez Hossain, MD, PhD, FRCOphth, FRCS (Ed)

Senior Lecturer & Consultant

Ophthalmic Surgeon

Division of Infection, Inflammation & Immunity

University of Southampton

Southampton General Hospital

Southampton

UK

Disclosures

PH declares that he has no competing interests.

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

References

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

Key articles

Rhee MK, Ahmad S, Amescua G, et al. Bacterial keratitis preferred practice pattern®. Ophthalmology. 2024 Apr;131(4):P87-133.Full text  Abstract

Herretes S, Wang X, Reyes JM. Topical corticosteroids as adjunctive therapy for bacterial keratitis. Cochrane Database Syst Rev. 2014 Oct 16;(10):CD005430.Full text  Abstract

Wilhelmus KR. Antiviral treatment and other therapeutic interventions for herpes simplex virus epithelial keratitis. Cochrane Database Syst Rev. 2015 Jan 9;(1):CD002898.Full text  Abstract

Reference articles

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
  • Ceratite images

  • Diagnósticos diferenciais

    • Abrasão da córnea
    • Ceratoconjuntivite vernal com úlcera em escudo
    • Olho seco ou ceratite por exposição
    Mais Diagnósticos diferenciais

  • Diretrizes

    • Bacterial keratitis preferred practice pattern
    • Cornea/external disease summary benchmarks - 2023
    Mais Diretrizes

  • Folhetos informativos para os pacientes

    Herpes-zóster: o que é?

    Infecção ocular por herpes simples

    Mais Folhetos informativos para os pacientes
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