Keratoconjunctivitis is when you have both keratitis and conjunctivitis at the same time.

Keratitis is inflammation of the cornea, the clear dome that covers the iris and the pupil. Conjunctivitis is inflammation of the conjunctiva. That’s the thin membrane over the white part of the eye and the inner surface of the eyelid. Conjunctivitis is also known as pink eye.

There are a lot of things that can cause keratoconjunctivitis, including allergies and infections. It’s not an uncommon condition and it’s estimated that as many as 6 million people in the United States seek care for eye inflammation every year.

Treatment is usually conservative and depends on the cause. The prognosis is generally good.

Continue reading to learn about the different types of keratoconjunctivitis, which ones are contagious, and how to relieve symptoms.

There are many potential causes, both infectious and noninfectious. They include:

The majority of cases of conjunctivitis and keratoconjunctivitis are due to allergies. When it comes to infections, viruses are the most common among all age groups. Bacterial conjunctivitis is more common among children.

Keratoconjunctivitis sicca

Keratoconjunctivitis sicca is commonly known as dry eye syndrome.

Tears are made up of water, fatty oils, and mucus. You need the right mixture of all three to properly nourish your eyes. Dry eye syndrome can happen from:

  • an imbalance in the tear mixture
  • not producing enough tears
  • tears evaporating too quickly

Epidemic keratoconjunctivitis

Epidemic keratoconjunctivitis (EKC) is an eye infection caused by human adenovirus. It’s also called viral keratoconjunctivitis or adenoviral keratoconjunctivitis.

EKC has a long incubation period and is highly contagious. That’s why large outbreaks happen all around the world. It spreads easily where people are in close quarters, like schools, hospitals, and even doctors’ offices.

There’s no specific treatment. Symptoms usually last a few weeks before clearing up. Adenoviruses also target the respiratory, digestive, and genitourinary tracts.

Phlyctenular keratoconjunctivitis

Phlyctenular keratoconjunctivitis (PKC) is triggered by microbial antigens. That includes staphylococcus, tuberculosis, and chlamydia.

One key symptom is the formation of nodules where the cornea meets the white of the eye. It can make you feel like there’s something in your eye.

Vernal keratoconjunctivitis

Vernal keratoconjunctivitis (VKC) is severe, chronic allergic inflammation of the eye. It can result in small, round bumps known as giant papillae underneath the eyelid. It tends to affect the upper eyelid more than the lower.

The cause isn’t always clear, but it may also involve genetic and immune system disorders. It can happen to anyone, but it’s more common in tropical locations and among young males.

Atopic keratoconjunctivitis

Atopic keratoconjunctivitis (AKC) is due to a genetic condition called atopy. Atopy makes you more likely to develop allergies. Men get AKC more often than women, and it affects the lower eyelid more than the upper.

Symptoms typically get worse in winter. Without treatment, AKC can lead to serious complications such as:

  • ulceration
  • keratoconus, which is the thinning and bulging out of the cornea
  • corneal vascularization, which is the growth of new blood vessels into the cornea

Herpetic keratoconjunctivitis

Herpetic keratoconjunctivitis is an infection caused by herpes simplex virus, particularly type 1. One way you might get this is by touching your eye after touching a cold sore near your mouth.

Superior limbic keratoconjunctivitis

Superior limbic keratoconjunctivitis (SLK) is a chronic, recurring eye inflammation. The cause is unknown. SLK is rare and affects women more often than men. Symptoms develop slowly over a span of 1 to 10 years before resolving.

Neurotrophic keratoconjunctivitis

Neurotrophic keratoconjunctivitis is a rare degenerative eye disease caused by nerve damage. It can cause you to lose feeling in your cornea, so you probably won’t have any pain. It can leave the cornea susceptible to injury. This is a progressive condition, so early intervention is crucial.

Allergic keratoconjunctivitis

Allergic keratoconjunctivitis refers to any keratoconjunctivitis caused by an allergen. Vernal and atopic keratoconjunctivitis, for example, are included in this group. Allergies can come on seasonally or occur year-round.

Symptoms range from mild to quite severe. They vary depending on the cause. Some symptoms associated with keratoconjunctivitis include:

If you have a history of allergies that affect your eyes, you probably don’t need to see a doctor every time it happens. Do see a doctor if you don’t know why your eyes are inflamed or you:

  • suspect you have an eye infection
  • see no sign of improvement after a week
  • splashed something potentially harmful in your eye
  • injured your eye
  • notice your vision is affected

Be sure to mention if you wear contact lenses or use eye drops or other eye products. Tell the doctor if you have a preexisting condition that may make you more prone to eye problems, such as genetic or autoimmune disorders.

In some cases, diagnosis can be made based on your medical history, symptoms, and visual inspection of the eyes. Depending on initial findings, a doctor may also want to examine:

  • visual acuity
  • underneath the eyelids
  • eye pressure
  • pupillary reactions
  • discharge
  • corneal sensation

In some cases, you may need to be tested for:

  • allergens
  • viruses
  • autoimmune diseases
  • genetic conditions

Treatment depends on the cause and severity of symptoms.

Avoid spreading to others

Some types of keratoconjunctivitis, such as EKC, are highly contagious. You can minimize the chances of spreading it by washing your hands well and often, especially after touching your face. Don’t share eye makeup, eye drops, or towels.

Before you see a doctor

When your eyes are irritated, it’s hard to think about anything else. Even if you have a doctor’s appointment, you’ll want relief as soon as possible.

The urge to rub those gritty, itchy eyes may be strong, but it’s important to fight that impulse. Rubbing and scratching are likely to make matters worse. Other ways to soothe symptoms include:

  • giving your eyes a rest from contact lenses
  • avoiding known allergens
  • not smoking and staying away from secondhand smoke
  • applying a cool or warm compress for 10 minutes
  • using a lid scrub every day to remove irritants and allergens
  • running a humidifier to moisten the air
  • steering clear of fans or heating and air conditioning vents that can dry your eyes
  • using preservative-free artificial tears to relieve dryness

Treating symptoms

Other treatment isn’t always necessary. Sometimes, you’ll need a combination of therapies which may include:

  • topical antihistamines or mast cell stabilizers
  • preservative-free lubricating gels and ointments
  • nonsteroidal anti-inflammatory agents
  • topical corticosteroids

If you have severe keratoconjunctivitis sicca or SLK, punctal plugs can be inserted. This may help your tears from draining from your eyes and lessen dry eye symptoms.

For the most serious cases of SLK, herpetic keratoconjunctivitis, or neurotrophic keratoconjunctivitis, there may be surgical options.

Treating underlying conditions

Some viral infections, such as herpes, may require treatment with topical or oral antiviral medications. Any underlying autoimmune or genetic conditions must also be addressed.

Keratoconjunctivitis is a group of inflammatory eye conditions involving the cornea and the conjunctiva. Allergies, viruses, and bacteria are among the causes. Some types are associated with congenital or autoimmune disorders.

There are steps you can take to relieve symptoms. You should also see a doctor for diagnosis. The good news is that keratoconjunctivitis often clears up on its own or with minimal treatment.