Frontiers in Ocular Therapy: Linking Nanoparticles to Patho- Therapeutic Outcomes in Keratitis Treatment

Keratitis is a critical inflammation of the cornea caused by chemical agents due to bacterial, fungal, or viral pathogens. It significantly contributes to the global burden of vision loss and blindness in older adults. Antimicrobial treatment helps fight different types of bacteria. Conventional treatments are less effective owing to poor ocular drug bioavailability, rapid tear clearance, and drug-resistant microbes. Recent developments in nanotechnology hold promise for circumventing these limitations via improved delivery, targeting, and combination therapies. This study provides a critical review of the pathogenesis of microbial keratitis and a systematic assessment of emerging therapeutic approaches based on nanotechnology, including piezodynamic therapy (PZDT), photothermal therapy (PTT), photodynamic therapy (PDT), nanoenzymes, and metal ions. The assessment of each modality is based on its mechanism of action, effectiveness against biofilm-embedded pathogens, ability to modulate immune responses, and potential use with advanced drug delivery systems, such as microneedle patches, functionalized nanoparticles, and responsive hydrogels. This review also highlights the role of nanocarriers in improving drug retention, reducing systemic toxicity, and enabling targeted drug delivery to infected corneal tissue. Toxicity, regulatory hurdles, and therapeutic consistency pose challenges to clinical translation. This review presents a comprehensive outlook on the potential of nanomedicine in keratitis therapy using microbiology, immunology, materials science, and clinical ophthalmology. The goal is to inform future research and foster interdisciplinary approaches that will result in treatments that are more effective, safer, and patient-focused for this vision-impairing condition. Nanotechnology-enabled ocular therapies may overcome existing drug delivery limitations and improve clinical outcomes in microbial keratitis, as noted in this review.