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A review of filamentary keratitis
Menachem Weiss1, Ryan Molina1, Chibuike Ofoegbuna1
1Department of Ophthalmology, Long School of Medicine, University of Texas Health San Antonio, San Antonio, TX, USA.
Abstract:
Filamentary keratitis (FK) is characterized by the presence of filaments on the corneal surface that are often associated with symptoms of foreign body sensation, irritation, and eye pain. FK is associated with a variety of ocular and systemic conditions, most notably dry eye disease. These filaments are composed primarily of epithelium, mucus, and cellular debris; however, their pathogenesis remains an area of debate. Aggravating factors for FK include desiccation, inflammatory mediators, as well as eyelid mechanical forces. Management consists of addressing associated conditions, especially dry eye disease, and providing medical and procedural treatments to alleviate symptoms and restore the ocular surface. Mainstay treatments include filament removal, increased lubrication with artificial tears and punctal occlusion, hypertonic saline, antiinflammatory and mucolytic medications, and autologous serum eye drops, as well as bandage contact lenses. A stepwise approach is required to manage patients with acute or chronic FK. Prolonged therapy is often necessary to prevent recurrence of this bothersome condition.
Insights
Filamentary keratitis (FK), marked by corneal filaments, often stems from dry eye disease. Treatment involves addressing underlying causes and using lubrication, anti-inflammatories, and other therapies to manage this recurring eye condition.
Area of Science:
- Ophthalmology
- Corneal Diseases
Background:
- Filamentary keratitis (FK) presents with corneal filaments, causing discomfort and pain.
- It is frequently linked to dry eye disease and other ocular/systemic conditions.
- The exact pathogenesis of these filaments, composed of epithelium, mucus, and debris, is debated.
Purpose of the Study:
- To summarize the characteristics, aggravating factors, and management strategies for filamentary keratitis.
- To highlight the importance of addressing underlying conditions, particularly dry eye disease.
Main Methods:
- Review of literature on filamentary keratitis.
- Analysis of contributing factors and current treatment modalities.
Main Results:
- Aggravating factors include desiccation, inflammation, and eyelid mechanics.
- Effective management requires a stepwise approach targeting associated conditions and symptoms.
- Key treatments include filament removal, lubrication, hypertonic saline, anti-inflammatories, and autologous serum eye drops.
Conclusions:
- Filamentary keratitis management necessitates addressing underlying causes like dry eye disease.
- A comprehensive, stepwise treatment plan is crucial for symptom relief and ocular surface restoration.
- Prolonged therapy is often needed to prevent recurrence of this persistent condition.
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