What are the common causes of fungal eye infections. How can you recognize the symptoms of a fungal eye infection. What treatment options are available for fungal eye infections. How can you prevent fungal eye infections.

Understanding Fungal Eye Infections: An Overview

Fungal eye infections, though rare, can pose serious threats to vision and eye health. These infections occur when various types of fungi enter the eye, often through injury or other means of exposure. While less common than viral or bacterial eye infections, fungal infections can lead to severe complications if left untreated.

The Centers for Disease Control and Prevention (CDC) reports that fungal eye infections are relatively uncommon. However, their potential severity underscores the importance of early detection and prompt treatment. This article delves into the causes, symptoms, treatment options, and prevention strategies for fungal eye infections.

Common Causes of Fungal Eye Infections

Fungal eye infections can be caused by various types of fungi. The most common culprits include:

• Filamentous fungi
• Aspergillus species
• Fusarium solani

These fungi typically enter the eye through one of two primary routes:

1. Direct injury to the eye, such as a scratch from a tree branch or plant thorn
2. Spread from a fungal infection elsewhere in the body

How do fungi typically enter the eye?

In most cases, fungi enter the eye through direct contact with contaminated objects or substances. This often occurs due to accidental injury, particularly when engaging in outdoor activities or working with plants. Less frequently, fungi can spread to the eyes from other parts of the body where a fungal infection is present.

Risk Factors for Developing Fungal Eye Infections

While anyone can potentially develop a fungal eye infection, certain factors can increase the risk. These include:

• Sustaining an eye injury, especially from plant materials
• Undergoing eye surgery
• Wearing contact lenses
• Having a fungal bloodstream infection
• Exposure to contaminated medical products

Are contact lens wearers at higher risk for fungal eye infections?

Yes, contact lens wearers face an elevated risk of fungal eye infections. This increased risk is primarily due to the potential for improper lens care, which can create an environment conducive to fungal growth. Proper hygiene and adherence to recommended care guidelines are crucial for contact lens wearers to minimize their risk.

Recognizing the Symptoms of Fungal Eye Infections

Identifying a fungal eye infection early is crucial for effective treatment. The onset of symptoms can vary, with some cases developing rapidly after exposure, while others may take several weeks to manifest. Common symptoms include:

• Severe eye pain
• Redness of the eye
• Excessive tearing
• Sensitivity to light
• Discharge from the eye
• Blurred vision

How quickly do symptoms of a fungal eye infection appear?

The timeline for symptom onset can vary significantly. In some cases, symptoms may develop rapidly within hours or days of exposure to fungi. However, in other instances, it may take several weeks for noticeable symptoms to emerge. This variability underscores the importance of seeking medical attention promptly if any unusual eye symptoms occur, regardless of recent exposure history.

Diagnosing Fungal Eye Infections

Accurate diagnosis of fungal eye infections is essential for appropriate treatment. The diagnostic process typically involves:

1. A comprehensive eye examination
2. Review of medical history and potential exposure risks
3. Collection of eye samples for laboratory analysis
4. Imaging studies, such as ocular ultrasound or CT scans, in some cases

What diagnostic methods are used to confirm a fungal eye infection?

Ophthalmologists employ various diagnostic techniques to confirm fungal eye infections. These may include corneal scraping for microscopic examination and culture, confocal microscopy to visualize fungal elements in the cornea, and polymerase chain reaction (PCR) testing to detect fungal DNA. In some cases, a small tissue sample (biopsy) may be necessary for definitive diagnosis.

Treatment Options for Fungal Eye Infections

Prompt and aggressive treatment is crucial for managing fungal eye infections and preventing vision loss. The treatment approach may vary based on the severity of the infection and the presence of fungal ulcers. Common treatment options include:

• Topical antifungal medications, such as natamycin eye drops
• Oral antifungal medications for more severe cases
• Intravenous antifungal drugs for the most serious infections
• Surgical intervention in some cases, particularly if fungal ulcers are present

How effective are antifungal treatments for eye infections?

Antifungal treatments can be highly effective when administered promptly and appropriately. The success rate varies depending on factors such as the type of fungus involved, the extent of the infection, and how quickly treatment is initiated. In many cases, a combination of topical and systemic antifungal medications is used to achieve the best outcomes. However, treatment can be challenging, and some cases may require prolonged therapy or additional interventions.

Preventing Fungal Eye Infections

While it may not always be possible to prevent fungal eye infections entirely, several measures can significantly reduce the risk:

• Wear protective eyewear when engaging in outdoor activities, especially in areas with dense vegetation
• Follow all pre- and post-operative instructions meticulously when undergoing eye surgery
• Practice proper hand hygiene, especially before handling contact lenses or applying eye makeup
• Adhere to recommended contact lens care guidelines, including proper cleaning and replacement schedules
• Remove contact lenses at the first sign of eye irritation or infection
• Use swim goggles when swimming in natural bodies of water

What are the most effective ways to prevent fungal eye infections for contact lens wearers?

For contact lens wearers, the most effective prevention strategies include:

1. Washing hands thoroughly before handling lenses
2. Using fresh, sterile solution for lens cleaning and storage
3. Replacing lenses and lens cases according to manufacturer recommendations
4. Avoiding wearing lenses while swimming or showering
5. Never sleeping in contact lenses unless specifically designed and approved for overnight wear
6. Promptly removing lenses and seeking medical attention if eye irritation or redness occurs

Long-term Outlook and Complications of Fungal Eye Infections

The prognosis for fungal eye infections can vary significantly depending on several factors:

• The type of fungus involved
• The extent and location of the infection
• How quickly treatment is initiated
• The patient’s overall health and immune status

Potential complications of untreated or severe fungal eye infections include:

• Corneal scarring
• Permanent vision loss
• Endophthalmitis (infection of the internal eye structures)
• Loss of the eye in extreme cases

Can vision loss from fungal eye infections be reversed?

The potential for vision recovery depends on the severity and duration of the infection. In cases where treatment is initiated early, and the infection is limited to the surface of the eye, vision can often be preserved or restored. However, if the infection has caused significant corneal scarring or has spread to deeper eye structures, some degree of permanent vision loss may occur. In such cases, additional interventions like corneal transplantation might be necessary to restore vision.

When to Seek Medical Attention for Eye Symptoms

Given the potential severity of fungal eye infections, it’s crucial to seek medical attention promptly if you experience any unusual eye symptoms. Consider consulting an eye care professional if you notice:

• Persistent eye pain or discomfort
• Sudden changes in vision
• Redness or swelling of the eye or eyelid
• Unusual discharge from the eye
• Increased sensitivity to light
• Any eye symptoms following an injury or exposure to potential contaminants

How urgent is it to seek medical care for suspected fungal eye infections?

Seeking medical care for suspected fungal eye infections should be considered urgent. Early diagnosis and treatment are crucial for preventing serious complications and preserving vision. If you suspect a fungal eye infection or experience any concerning eye symptoms, it’s advisable to consult an eye care professional within 24 to 48 hours. In cases of severe pain, sudden vision loss, or symptoms following an eye injury, immediate emergency care may be necessary.

Fungal eye infections, while rare, represent a significant threat to ocular health and vision. By understanding the causes, recognizing the symptoms, and taking appropriate preventive measures, individuals can reduce their risk of developing these serious infections. Should symptoms arise, prompt medical attention and adherence to prescribed treatments are essential for achieving the best possible outcomes. As research in this field continues, new diagnostic techniques and treatment options may emerge, offering hope for improved management of fungal eye infections in the future.

Fungal Eye Infections | National Fungal Disease Awareness Week

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Skin Conditions Around the Eyes

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There are a number of conditions that affect the skin around the eyes and eyelids. Find out what they are and how these skin conditions can be treated.

Eyelid Contact Dermatitis

Eyelid cosmetics and cleansers can cause an irritant or allergic reaction in patients sensitive to them, triggering itching, burning and redness together with blistering and scaliness. If an allergy is suspected, a patch test can be done to confirm this and to ascertain the cosmetic or chemical responsible. Avoidance of the cosmetic will cure the condition.

Eye drops, contact lens and medicaments may also cause eyelid contact dermatitis. If you have eyelid dermatitis, you should consult your doctor. Eyelid dermatitis treatment may involve creams, and you may be referred to a dermatologist for an allergy test if necessary.

Atopic Dermatitis Skin Condition

Atopic dermatitis is a genetic skin disorder and often affects the eyelids. The skin may be red and scaly, and oozing and itching are common.

Sometimes the eye lining and eyelids are also affected, resulting in a sore eye. There is watery eye discharge, and patients may find their eyes sensitive to light. If the eyelid or eye itself is affected, your doctor will prescribe some eye drops and creams. Many patients are also allergic to house dust, which can aggravate eye inflammation.

Bacterial Skin Infection (Impetigo or Conjunctivitis)

Like the skin elsewhere, the eyelids can be infected by bacteria. The eyes will show a thick, sticky, yellow discharge, and the eyelids may be red with yellow crusts. Impetigo is most commonly seen in children. Good hygiene and antibiotics are needed to clear bacterial infections.

Xanthelasma Skin Condition

These are flat to slightly raised yellowish plaques on the upper and lower eyelids. They are associated with high blood cholesterol or triglycerides levels in about 20 percent of people with this condition. Sometimes there will be a family history of similar problems. The xanthelasma can be excised surgically or by laser or chemical treatment. Such lesions may recur. Patients with high cholesterol or triglyceride should have their lipid level controlled before surgery.

Syringoma

These are tiny, harmless skin-coloured growths on the eyelids, which may run in families. Syringoma are enlarged, underdeveloped sweat glands that usually appear during adolescence and adulthood. Most people choose to leave these skin growths alone, but they can be removed surgically by laser or excision for cosmetic reasons.

Skin Tags

Skin tags are small, harmless skin-coloured outgrowths of skin that can be seen around the eyes and eyelids. Similar outgrowths are often also seen on the neck and chest. Treatment is not necessary, but they can be easily removed surgically for cosmetic reasons. 

Milia

These are small white or yellowish-white skin growths often seen on the eyelids or temple and are caused by obstructed sweat ducts. They are very small and resemble millet seeds. They can be removed surgically for cosmetic reasons.

Dark Rings Around The Eyes

Darkened pigmentation of the eyelids is common in many dark-skinned people. In many cases, the darkening seems to vary with stress or lack of sleep. There is no effective treatment for the condition, which may be inherited or constitutional, but the condition is benign and is not a sign of illness.

Naevus of Ota Skin Condition

This is a birthmark that occurs at birth or shortly after birth as a patch of blue-black discolouration on the cheek, temple and eyelids and on the white of the eye. Usually, one side of the face is affected, although occasionally, discolouration appears on both sides of the face. The pigmentation can be reduced by pigment laser surgery. Patients will require multiple treatments at two- to three-monthly intervals. Only the pigmentation on the skin can be treated.

Strawberry Naevus

These are vascular birthmarks (birthmarks in the veins). They can appear as a large, red, soft growth on the eyelids. The growth will continue to enlarge and grow as the baby grows older, but the growth will slowly regress spontaneously when the child is three to four years old. If the vascular growths are small, they can be left alone to await spontaneous regression. If large and encroaching on the eyelid, vision may be affected, and the child should then receive treatment. Treatment options include oral medication, injections and laser surgery.

Port-wine Stain

These are also vascular birthmarks, which appear as flat, red patches on the eyelids and the cheek at birth. The vascular birthmarks increase in thickness, and small blebs (irregular bulges) of blood vessels may be seen. Unlike strawberry naevus, port-wine stains do not disappear spontaneously as the child grows older, and treatment is necessary. Most port-wine stains respond to vascular laser. Patients will need multiple laser treatments at three-monthly intervals to achieve optimal results.

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Skin Conditions Around the Eyes

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Fungal infections of the eyes

Ophthalmomycosis | Keratomycosis

Fungal infections of the eyes

Fungal infections of the organ of vision have been known for over 100 years. For a long time, this pathology was considered very rare, the types of fungi dangerous to the eyes were counted in units, publications about the diseases they cause were mostly casuistic.

However, since the 1950s, reports of such diseases have become more frequent. Quite often, a significant number of observations are given, previously unknown ones are described.0009 fungal infections of the eyes and representatives of the fungal flora that cause them new to ophthalmologists.

The clinic, diagnosis and prevention of fungal infections of the eyes are being specified, more effective methods of treating ophthalmomycosis are offered.

Currently, up to 50 species of fungi are considered pathogenic for the organ of vision. The most important of them are yeast-like, moldy mycetes, dermatophytes, etc.

In the majority of patients with ophthalmomycoses, fungi penetrate into the tissues of the eye from the environment or are introduced from mycotic foci on the skin and mucous membranes of other parts of the body, less often they come from such and deeper sources by the hematogenous route.

Exogenous infection with fungi usually causes mycoses of the appendages and anterior part of the eyeball. Endogenous drift often causes severe intraocular processes.

Of great importance in the inoculation of a fungal infection in the tissue of the eyelids, conjunctiva and eyeball are damage to the latter, often small abrasions and erosion, superficial foreign bodies of the conjunctiva and cornea, especially derivatives of the plant world.

For example, out of 33 observed by F. M. Polack et al. (1971) patients with keratomycosis only 4 had no history of eye damage. Fungi penetrate inside the eye with perforated wounds. More often than others, ophthalmomycosis affects rural residents, workers in elevators, granaries, mills, cotton gins, weaving mills, feed mills, livestock breeders, etc.

Fungal diseases occur more easily and proceed worse, especially in early childhood, when the body is weakened due to general infections, malnutrition, and metabolic disorders. For such patients, even the most harmless fungi, human saprophytes, become pathogenic.

Unlike infectious eye diseases of bacterial and viral origin, drug therapy is ineffective in fungal diseases. All authors unanimously recognize the wide, not always rational, local and general use of antibiotics and corticosteroids for the treatment of various human diseases as one of the important reasons for the growth of fungal eye diseases in recent decades.

The validity of this opinion is confirmed by clinical observations and experimental studies. So, H. V. Nema et al. (1968) after a month’s treatment of the conjunctiva, a previously absent fungal flora was found in the conjunctival sac in 41.2% of patients treated with hydrocortisone and in 28.7% of patients treated with tetracycline. Similar data are given by L. Nollimson et al. (1972) for betamethasone and neomycin. According to I. I. Merkulov, antibiotics violate the antagonistic relationship between bacteria and fungi in favor of the latter, and corticosteroids reduce the protective ability of tissues. In addition, some fungi, notably Candida albicans and Aspergillus niger, grow better and become more pathogenic in the presence of corticosteroids. The growth of fungi, especially Candida albicans, is also promoted by B vitamins.

The noted features of a fungal infection are characteristic not only of eye processes; they appear in many other localizations of mycoses. Nevertheless, it is important for ophthalmologists that the organ of vision is no exception to the general patterns of human fungal infections. If a patient seeking eye care developed an inflammatory disease of the eye against the background of mycosis of other parts of the body, the disease was preceded by even a minor injury, according to the conditions of life and work, the patient could become infected with a fungal infection, and an attempt to treat with antibiotics, sulfonamides, corticosteroids was unsuccessful, then there is every reason suspect ophthalmomycosis .

In cases where the clinical picture of eye disease has signs characteristic of a fungal infection, the above factors are additional data. However, to establish an accurate diagnosis of ophthalmic mycosis , it is necessary to isolate the culture of the fungus, determine its type, confirm that it was this pathogen that caused the eye disease in this patient, and clarify the sensitivity of the isolated culture to antimycotic agents. Quick and unambiguous answers to the questions posed can not always be obtained.

In wide practice, the etiology of an eye disease is often assessed as mycological only on the basis of anamnestic data, the clinical picture of the eye process, the detection of extraocular foci of mycosis, and trial treatment with antimycotic agents. Naturally, with this approach, part of ophthalmomycosis , especially when layered on viral and bacterial eye diseases, remains unrecognized. It is advisable to resort to laboratory mycological studies in case of suspicion of ophthalmomycosis as often as possible.

Despite the variety of pathogens and manifestations of fungal infections of the eye, their clinic is characterized by some common qualities.

Thus, the incubation period from the time of the introduction of a fungal infection to the appearance of the first signs of eye disease ranges from 10 hours to 3 weeks. Symptoms tend to develop slowly, and the process is often chronic without a tendency to spontaneous remission.

There are always external manifestations of inflammation expressed in varying degrees:

• hyperemia,
• purulent discharge,
• tissue infiltration and ulceration,
• Delayed defect repair.

A number of fungal invasions of the eye are inherent

• granuloma-like nodules in the skin of the eyelids, conjunctiva, orbit, vascular tract,
• their suppuration with the occurrence of fistulas, skin bridges,
• the presence of grains from the mycelium of the fungus in the discharge,
• formation of calculi in lacrimal ducts and conjunctival glands,
• crumbly character of infiltrates,
• their yellowish or greyish-yellow color, etc.

At the same time, most fungal infections of the eye are characterized by individual differences, depending on the type of fungi, localization and prevalence of the lesion, the condition of the tissues preceding mycosis, general health, body reactivity, even hereditary predisposition to fungal diseases. The first group of signs facilitates the general diagnosis of mycosis of the eye, the second helps to suspect a certain type of fungus, which is important when choosing methods and means of treatment.

Histologically, in preparations and sections of eye tissues affected by fungi, violations of the integrity of the epithelium and perforation of its cells, nonspecific granulomas of leukocytes, lymphocytes, histiocytes, epithelioid and other cells, pskrobio.ch and dystrophic changes around such granulomas are determined.

With the help of special stains (methods of Gridl, Gomori, etc.) in such preparations, as well as in scrapings from conjunctival and cornea ulcers, mycelium and spores of the pathogen are often detected. Some types of fungi, such as Candida albicans, cause only leukocyte and eosinophilic infiltration of the membranes and suppuration of the internal ones; environment of the eyeball.

Fungal pathology of the eye and its auxiliary apparatus is caused not only by the direct introduction of pathogens into their tissues.

It often develops as an allergic reaction to fungal allergens coming from mycotic foci distant from the eye. With persistent eye processes that have not been cured for years, such foci are found under the crowns and bridges of the teeth in the oral cavity, in the interdigital folds of the legs, and in the vagina. Sometimes the cause of allergies was onychomycosis. A pronounced reaction to trichophytosis (skin test) and a quick recovery of the eyes after the elimination of extraocular foci are strong evidence of the allergic nature of this pathology.

Treatment of fungal diseases of the organ of vision

The treatment of human fungal diseases in general is currently carried out primarily with special antimycotic agents, the arsenal of which is significant, and the effectiveness is quite high.

Timely started and carried out purposefully selected in accordance with the clinical data and characteristics of isolated cultures of pathogens therapy is the most successful. More often than other means of such therapy in general mycology, antifungal antibiotics are resorted to: nystatin, which is active against yeast-like and mold fungi, amphotericin B and amphoglucocamine, which affects the pathogens of coccidioidomycosis, cryptococcosis, blastomycosis, mold and other fungi, levorin, which affects fungi of the genus Candida, griseofulvin, effective for epidermophytosis, trichophytosis, microsporia. Of the other fungicides acting on fungi, they are used, mainly in dermatology, decamin and decamethoxin, useful for candidomycosis, nitrofurilen, nitrofran, esulan, amikazol, Zinkundan ointments. “Undecin” and a number of other drugs.

When prescribing general treatment with fupgicides, one should be strictly guided by the said manual, since many of these drugs, especially amphotericin B, griseofulvin, and others, are characterized by increased toxicity. There are many contraindications to their appointment, they require compliance with a number of conditions for their use. Ophthalmic forms of fupgistatics for topical use are: eye drops (0.25%, 0.5% and 1%) and eye ointment (0.5%) amphotericia B, eye drops (1% and 2.5%) and eye ointment (2.5%) levorin, eye drops (1%), solution for injection under the conjunctiva (1-2.5%)) and eye ointment (5%) nystatin. Prescription solution for injection under the conjunctiva of amphotericin B (0.015 g in 0.2 ml of water), eye drops of grisemin (0.5%) and dekamin (0.1%) are given in the reference book on ophthalmology, published in 1967 g. Using the recipes given in these reference books, ophthalmologists have the opportunity to supplement the general treatment of ophthalmomycosis with the local appointment of the most effective antifungal agents, sometimes limiting themselves to local treatment, and also use these agents to sanitize the conjunctival cavity from fungal flora. Successfully tested in ophthalmology electrophoresis of antifungal drugs.

In the treatment of certain types of fungal infection of the organ of vision, iodine preparations, aniline dyes, and disinfectants that have been used for a long time have not lost their value. Quite often, good results are obtained by surgical interventions from simple curettage of foci and opening of abscesses to keratoplasty and vitreectomy.

Weather, fungus and 8 more reasons why eyes burn

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If your eyes feel uncomfortable after prolonged exposure to the sun or working at the computer, burning occurs – this is unpleasant, but most often not dangerous. But sometimes burning eyelids can be a sign of a serious problem.

August 6, 2022

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Our eyes give us up to 90% of information about the world around us. Therefore, it is important that the vision is sharp, and you do not experience any discomfort during visual stress. But there are situations when the eyes are irritated, itching or burning, a feeling of sand in the eyes. Often this is also accompanied by reddening of the proteins, we rub our eyes, often only worsening the situation and increasing irritation.

But when is the burning sensation unpleasant, but not dangerous, and when is it urgent to see a doctor? Vladimir Ageev, an ophthalmologist, candidate of medical sciences, answered these questions for Doctor Peter.

There are many reasons, but not all are dangerous

Burning and itching in the eyes can be caused by various reasons – both external factors and health problems. In the first case, it is not difficult to solve the problem: it is enough to eliminate the “irritant”, give your eyes a rest, apply something cold to them or drip drops. However, if the symptom occurs regularly and causes severe discomfort, then you should consult an ophthalmologist (oculist). We will single out two groups of causes of burning – those that are not related to vision and the second group – problems that are directly related to it.

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Factors not related to vision

In these cases, there are no problems with the eyes themselves, but negative external influences can provoke burning and redness, discomfort.

Bad ecology

Very often, burning in the eyes is associated with the negative impact of the environment. Exhaust fumes, smog, smoke from factory chimneys, dust on the streets – all these factors can irritate the eye membrane, cause itching and a “sandy feeling” in the eyes.

Abuse of gadgets and long work at the computer

The problem of “burning” eyes and eyelids is often faced by representatives of professions related to working at a computer. This symptom accompanies eye strain, which occurs due to too much sitting in front of the monitor and the abuse of various gadgets. The best prevention in this case will be a simple observance of visual hygiene – small but regular breaks, gymnastics for the eyes, a properly equipped workplace, etc.

Sunburn

Contrary to popular misconception, our eyes can get sunburnt. However, like any other part of the skin. To protect from the sun’s rays, before going out, do not forget to apply eye protection to the area around the eyes. If it was not possible to prevent a burn, use ointments or creams with panthenol or aloe extract. They will relieve burning sensation, cool and moisturize damaged skin.

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Heat

The combination of high temperatures and dry air adversely affect the tear film, which is responsible for protecting and moisturizing the cornea of ​​the eye. Due to the heat, it dries out too quickly and does not have time to recover in time.

Reaction to aggressive substances

Burning eyes is a common reaction to contact with aggressive substances. First of all, chemical origin. These can be components of cosmetics, chlorinated water in pools, household chemicals. Itching can also be caused by organic compounds found in certain foods. For example, onions and chii peppers give this effect.

Allergic reactions

Burning eyes are considered a common side effect of allergies. In this case, pollen, animal hair, mold and fungal spores can act as allergens.

Related to vision

In addition to external factors, there are a number of causes of burning that are directly related to the organ of vision and are caused by various ophthalmological diseases.

Conjunctivitis – inflammation of the mucous membrane

Itching and burning are typical symptoms of conjunctivitis – inflammation of the mucous membrane of the eye. This disease is usually either associated with allergies, or manifests itself against a bacterial or viral infection.

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Blepharitis – inflammation of the eyelids

Blepharitis is a whole complex of eye diseases characterized by inflammation of the eyelids. In most cases, the disease is chronic. In addition to burning in the eyes and eyelids, its symptoms include redness and swelling along the contour of the eyelids, increased tearing and eye fatigue, loss and gluing of eyelashes.

Keratitis is an inflammation of the cornea

Keratitis is an inflammation of the cornea of ​​the eye.