Anna Nowińska

By Anna Nowińska

The chapter is focused on one of the major cause of keratitis - Herpetic keratitis, its epidemiology, natural course, clinical forms, prognosis, diagnosis and treatment. The estimated global incidence of HSV keratitis is roughly 1,5 million, including 40,000 new cases of each year. Patients are usually affected in the early decades of live, therefore the disease has a severe impact on quality of life and quality of vision in young, productive adults. The author describes the detailed corneal characteristics, provides slit lamp photographs, optical coherence tomography scans and confocal microscopy results of different forms of the HSV keratitis: epithelial, stromal, necrotizing and endothelial. The chapter also discusses recent methods of diagnosis based on PCR testing as well as established and future methods of treatment based on the latest research results.

Part of the book: Infectious Eye Diseases

By Edyta Chlasta-Twardzik and Anna Nowińska

Bacterial keratitis is a disease prevalent in the underdeveloped and developing worlds and is a significant cause of vision-threatening keratitis across the globe. Early and exact diagnosis, accurate treatment, and regular follow-up are key determinants of success in these cases and allow to prevent serious complications and ensure optimal patient outcomes. This chapter provides a comprehensive overview of the causes, symptoms, diagnosis, and management of bacterial keratitis. The importance of accurate diagnosis based on culture of corneal scraping, and smear examinations, as well as with the use of diagnostic tools, such as confocal microscopy is highlighted. Treatment options, including medical treatment and surgical interventions, are discussed in detail. Moreover, the chapter provides insights into the latest research and developments including new treatments. It also highlights the need for ongoing monitoring, regular follow-up, and good compliance between patient and doctor to ensure optimal patient outcomes. The patient must be educated to avoid risk factors. The superficial ulcer usually responds well to medical management, whereas deeper non-resolving ulcers require therapeutic penetrating keratoplasty for globe salvage. Overall, this chapter serves as an important resource for clinicians, researchers, and healthcare professionals, providing valuable information on the diagnosis and management of bacterial keratitis.

Part of the book: Keratitis

By Anna Nowińska

Ocular surface inflammation is one of the major features of dry eye disease (DED) according to the definition proposed by the Tear Film and Ocular Surface Society (TFOS) International Dry Eye Workshop (DEWS) in 2007 and 2017. This chapter discusses the potential pathomechanism of the DED vicious cycle and focuses on the role of chronic inflammation and flares in DED pathophysiology. Ocular inflammation may be regarded as both a cause and effect of DED. The current understanding of the mechanism responsible is that the repeating desiccating stress accompanied by hyperosmolarity induces the immune system reaction, leading to the chronic inflammation and apoptosis of ocular surface cells. On the cellular level, there is growing evidence from experimental, animal, and human studies that Th17 lymphocytes play a crucial role in DED pathogenesis. Also, potential methods of anti-inflammatory methods of treatment are discussed, such as eye lubricants, autologous serum eye drops, topical steroids, oral and topical immunomodulation drugs, and N-acetylcysteine (NAC). Understanding the role of inflammation on the cellular and molecular level may lead to improve treatment options for patients. A new approach to DED treatment should be focused to target not only symptoms but also break the pathological dry eye cycle.

Part of the book: Keratitis