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Dr. Chrysoula I. Liakou MD, PhD
- Treated online: Recognition and fast routing only: keratitis needs in-person ophthalmology with slit-lamp examination on the day it is suspected, above all in contact-lens wearers with a painful red eye, and is never managed online.
- What it is: inflammation of the cornea from bacteria, viruses (herpes simplex above all), fungi, the amoeba Acanthamoeba, UV light or an injury; contact lenses are the main risk factor, raising the risk about 10-fold with overnight wear.
- Symptoms: real eye pain rather than grittiness, light sensitivity, blurred vision, watering and redness, usually in one eye, sometimes with a visible white spot on the cornea.
- Why it is urgent: an infected cornea can ulcerate and scar within 24 to 48 hours, and central scarring permanently affects sight; treatment is intensive drops adjusted in person, sometimes hourly at first.
- Never: use leftover steroid or anaesthetic drops on a painful red eye; they can mask progression or accelerate the infection.
- Emergency: call 112 if vision is disappearing, an injury has penetrated the eye, or someone is severely unwell; a contact-lens wearer with a painful red eye goes to emergency eye care now.
If you wear contact lenses and have a painful red eye, or anyone has real eye pain with light sensitivity, blurred vision or a visible white spot on the cornea, go to same-day in-person eye care now: emergency ophthalmology or the nearest emergency department. Do not wait for an online slot to do that. Book here when you are unsure what your red eye is and want it triaged fast, honestly, with directions you can act on today.
Can keratitis be treated online?
No. Keratitis needs same-day in-person care: diagnosis requires slit-lamp examination of the cornea, often with samples taken before treatment, and management can involve intensive prescription drops adjusted day by day.[1] What an online doctor can responsibly do is recognise the pattern from your symptoms, separate it from milder red eyes, and route you to the right service the same day.
That routing role is worth something real. Corneal infection and scarring remain significant causes of visual impairment worldwide,[3] and outcomes track how fast treatment starts. The failure mode is familiar: a lens wearer with a sore red eye waits three days hoping it is conjunctivitis. An honest triage consultation exists to break exactly that delay, and the doctors on Mobi Doctor are explicit that with keratitis the consultation buys speed and direction, not treatment.
How an online consultation helps with suspected keratitis
- Clear recognition: the combination of true pain, light sensitivity, vision change and lens history is assessable by video, and the doctor tells you plainly whether your red eye carries keratitis risk.
- Same-day routing, said clearly: if the picture fits, the instruction is unambiguous: emergency eye care today, with a summary of what to tell them, not drops and hope.
- Sorting the milder red eyes: most red eyes are conjunctivitis, dryness or lid disease. When yours is one of those, you get that diagnosis and its treatment instead of an unnecessary emergency trip.
- Aftercare and prevention: once a specialist has treated keratitis, follow-up questions, recovery expectations and the lens-hygiene overhaul that prevents the next episode suit online care well.
📷 If it does not delay you, a daylight photo of the open eye can help: a white or grey spot on the cornea, the clear window over the coloured iris, is a red-flag finding. But with keratitis the rule is reversed from our other eye pages: photos are optional, speed is not. Never spend an hour perfecting pictures when the advice you need is to be seen today.
What are the symptoms of keratitis?
Keratitis typically causes real eye pain rather than grittiness, sensitivity to light, blurred or reduced vision, redness concentrated around the iris, watering, and sometimes a visible white spot on the cornea. A feeling that something is stuck in the eye when nothing is there is common. Symptoms in a contact-lens wearer raise the stakes immediately.[1]
- Pain, not grit: an ache or sharp pain that painkillers barely touch, distinct from the sandy irritation of dry eye or conjunctivitis.
- Photophobia: normal room light feels harsh; bright light is difficult to face.
- Vision change: blurring that blinking does not clear, or haloes around lights.
- A white corneal spot: an infiltrate or ulcer sometimes visible to the naked eye, always an emergency sign.
- One eye, usually: keratitis is typically one-sided, unlike allergic or viral conjunctivitis which often involve both.
What the doctor checks in an online keratitis consultation
The assessment is a structured risk triage, built to answer one question: does this red eye need a slit lamp today? The doctor will typically assess:
- Pain quality and light sensitivity: the two symptoms that most reliably separate corneal trouble from surface irritation.[1]
- Vision, tested pragmatically: on video, whether you can read text across the room with each eye, and whether blinking clears any blur.
- Contact-lens history, in detail: lens type, sleeping in lenses, showering or swimming in them, tap water anywhere near lenses or case, and how old the case is, each a known route to microbial keratitis, including the water-borne organism acanthamoeba.
- Injury and exposure: scratches from nails, branches or grit, chemical splashes, and unprotected exposure to welding arcs, sunbeds or high-altitude snow, which cause UV keratitis.[2]
- Cold-sore history: previous herpes simplex eye disease or recurrent one-sided "conjunctivitis", because herpes keratitis recurs and needs specific in-person treatment.[4]
- The cornea on camera: any visible white spot, and how you tolerate the light of your own screen during the call.
Why do contact-lens wearers with a painful red eye need same-day care?
Because in a lens wearer, a painful red eye is treated as microbial keratitis until a slit-lamp examination proves otherwise. Lenses create the conditions bacteria and amoebae need: micro-scratches on the cornea, reduced oxygen, and a warm, moist surface held against the eye. An infected cornea can ulcerate and scar within days, and a central scar permanently damages sight in that eye.[1]
This is the centrepiece rule of this page, and it has no soft version: lens wearers do not get a wait-and-see option for a painful red eye. Same-day ophthalmology allows the cornea to be examined, samples to be taken from an ulcer before treatment, and intensive drops to be started and adjusted properly. Until then: lenses out and binned along with the case, glasses on, no rubbing, and no anaesthetic or steroid drops from a drawer, because numbing masks progression and steroids can accelerate an unrecognised infection. Take your lens details with you; the organisms behind lens-related keratitis influence exactly which treatment is chosen.
What causes keratitis?
Infectious keratitis is caused by bacteria (the classic lens-related infection), viruses (herpes simplex, which recurs and can scar with each episode), fungi (often after plant or soil injuries) and acanthamoeba (linked to water contact with lenses). Non-infectious keratitis follows UV exposure (welder's flash, snow blindness), injury, severe dryness or inflammation of the surface.[1][2] The distinctions matter because treatments differ sharply, one more reason diagnosis belongs with a slit lamp rather than a video call. UV keratitis deserves its own mention for travellers: hours after unprotected exposure on snow, water or a sunbed, both eyes become painful, red and light-sensitive. It usually heals within a day or two with lubrication and pain relief, but first-episode diagnosis should still be made in person, since "both eyes after obvious UV exposure" is a story easily misapplied to something else.
Red eye triage: which route does yours need?
This is the routing framework the doctors use for red eyes where keratitis is the question, aligned with the cited guidance:[1]
Swipe sideways to compare →
| Presentation | Likely first step | Suitable for online care? | When referral or in-person care is needed |
|---|---|---|---|
| Contact-lens wearer with a painful red eye | Same-day emergency ophthalmology; lenses out and kept off | No, beyond routing | Always, the same day, without exception |
| Painful, light-sensitive red eye, or any white spot on the cornea | Same-day in-person eye assessment with slit-lamp examination | No, beyond routing | Always; keratitis and other serious causes must be excluded |
| Previous herpes eye disease with a recurrence of one-sided pain and redness | Urgent in-person assessment for antiviral treatment | Recognition and urgent referral | Always, promptly; each episode risks further scarring |
| Both eyes painful and light-sensitive hours after welding, snow or sunbed exposure | In-person confirmation of UV keratitis; lubricants and pain relief while it heals | Follow-up, once diagnosed | First episode, worsening, or not clearly better within 48 hours |
| Gritty, itchy or sticky red eye: normal vision, no real pain, comfortable in light | Assessment for conjunctivitis, dry eye or lid disease, treated on their own pages | Usually yes | Any onset of pain, light sensitivity or vision change during treatment |
A red eye and not sure how urgent it is? A doctor can tell you in one consultation.
See available times →How keratitis is treated (in person)
It helps to know what the same-day trip buys you. An ophthalmologist examines the cornea under a slit lamp with fluorescein dye, and an ulcer is usually scraped for microbiology before treatment so the organism can be identified. Bacterial keratitis is treated with intensive antibiotic drops, initially sometimes hourly, adjusted as results return; herpes keratitis gets specific antivirals; acanthamoeba and fungal disease need specialised, prolonged regimens.[1][5] Steroid drops sometimes join later to limit scarring, but only under specialist supervision, because used on the wrong infection at the wrong moment they make keratitis worse, which is one of the clearest reasons no responsible online doctor treats this condition remotely. Started early, treatment usually preserves sight; started late, scarring can be permanent. Speed is the whole game.
When keratitis is assessed online, and when you need in-person care
This section is the heart of the page, and the rule is deliberately strict.
Assessed online: triage a red eye fast when you are unsure what it is; recognise the keratitis pattern and send you to same-day emergency eye care with a clear summary; identify the red eyes that are actually conjunctivitis, dry eye or blepharitis and treat those properly; support recovery after specialist treatment, including return-to-lenses decisions; and rebuild lens hygiene so it does not happen twice.
What always goes in person, same day: every suspected keratitis, every contact-lens wearer with a painful red eye, every painful light-sensitive eye, every white corneal spot, every recurrence of herpes eye disease, and every red eye after injury or chemical exposure. Keratitis is never diagnosed or prescribed for online, and this page says so before you book: if the doctor concludes within the consultation that you need emergency care, you get that instruction, the refund promise applies as everywhere on this site, and the consultation will still have done its job by getting you moving.
When to get in-person care
Same day, always: a painful red eye in a contact-lens wearer, real eye pain with light sensitivity, blurred or reduced vision, or a white spot on the cornea. Rinse a chemical splash with clean water for 15–20 minutes and go straight to emergency care. If vision is disappearing, an injury has penetrated the eye, or someone is severely unwell, call 112 immediately.
How Mobi Doctor works
- Book a time that suits you: open daily 7am–11pm CET. You can see a doctor over video, usually within 15 minutes. No subscription, exact price up front.
- Describe your symptoms to a licensed doctor: a private video call from anywhere in Europe; add a photo only if taking it causes no delay at all.
- Get a clear verdict: same-day emergency routing for suspected keratitis, or diagnosis and treatment when it is a milder red eye, or full refund.
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Frequently asked questions about keratitis
What is keratitis?
Keratitis is inflammation of the cornea, the clear dome at the front of the eye that focuses light. It is usually caused by infection with bacteria, a virus such as herpes simplex, fungi or the amoeba Acanthamoeba, or by injury, dryness or UV exposure. Unlike conjunctivitis, keratitis is painful and blurs vision, and because the cornea can scar within days it is treated as an emergency.
What are the symptoms of keratitis?
Keratitis causes real eye pain rather than grittiness, marked sensitivity to light, blurred or reduced vision, redness, watering, a feeling that something is in the eye, and sometimes a visible white or grey spot on the cornea. It is usually in one eye. In a contact-lens wearer, any of these means the lenses come out and the eye is examined in person the same way, without waiting.
What causes keratitis?
Infective keratitis is caused by bacteria entering through a scratched or lens-worn cornea, by herpes simplex or shingles viruses, by fungi after an injury with plant material, or by Acanthamoeba from tap water, pools or hot tubs reaching contact lenses. Non-infective keratitis follows UV exposure (welding, snow, sunbeds), severe dry eye, an inward-turning lash or an injury. Contact lenses, especially worn overnight or in water, are the biggest risk factor.
Is keratitis an emergency?
Treat keratitis as an emergency. Keratitis can ulcerate and scar the cornea within days, and central scarring permanently affects sight. A painful, light-sensitive red eye, any white spot on the cornea, and any painful red eye in a contact-lens wearer need in-person eye assessment on the day they appear: emergency ophthalmology or the nearest emergency department.
How is keratitis different from conjunctivitis?
Conjunctivitis feels gritty rather than painful, vision stays essentially normal once you blink away discharge, and light is tolerable. Keratitis causes real pain, light sensitivity and blurred vision, usually in one eye, sometimes with a white spot on the cornea. When the two cannot be told apart from a video assessment, the eye is examined in person rather than assumed to be the milder one.
Can an online doctor prescribe treatment for keratitis?
No, an online doctor cannot safely prescribe treatment for keratitis, and be wary of anyone who offers to. Keratitis needs slit-lamp examination, often corneal sampling, and intensive treatment adjusted in person; the wrong drops, especially steroids, can make it worse. The online role is recognition, clear routing, and sorting out the milder red eyes that can be treated by video.
I wear contact lenses and my eye hurts. What should I do right now?
Take the lenses out and do not reuse them or the case, put glasses on, avoid rubbing, and arrange in-person eye assessment now: emergency ophthalmology or an emergency department. Do not use leftover drops, especially steroid or anaesthetic ones. Bring the lenses and case with you if you can, because they can be cultured if keratitis is confirmed.
How is keratitis treated?
Keratitis is treated in person according to its cause: intensive antibiotic drops, sometimes hourly at first, for bacterial infection; antiviral drops or tablets for herpes keratitis; antifungal or anti-amoebic drops over weeks for the rarer types; and lubricants, pain relief and a patch or protective lens for UV or injury-related keratitis. Steroid drops are used only by the specialist, once infection is controlled.
Is keratitis contagious?
Keratitis itself is not passed between people, though the viruses behind herpes keratitis spread by close contact and the bacteria involved spread on hands and lenses. Do not share towels, lenses, lens cases or eye make-up, wash hands before touching the eyes, and never rinse lenses in tap water, which is where Acanthamoeba lives.
How long does keratitis take to heal?
Keratitis takes anywhere from a day or two to several months to heal, depending on the cause and speed of treatment. UV keratitis usually settles within 24 to 48 hours. Bacterial keratitis treated promptly often heals over one to a few weeks; fungal and Acanthamoeba keratitis can take months. Herpes keratitis can recur, so people who have had it keep antiviral treatment on hand with specialist guidance.
Can I wear contact lenses again after keratitis?
Often yes, but only once the eye has fully healed and your specialist agrees, usually with a hygiene overhaul: fresh lenses and case, no sleeping, showering or swimming in lenses, no tap water near them, and consideration of daily disposables. After Acanthamoeba or a severe bacterial keratitis, some people are advised to stop lenses for good.
How can I prevent keratitis?
Prevent keratitis by handling contact lenses only with washed, dried hands, never sleeping, showering or swimming in them, never using tap water on lenses or cases, replacing cases every three months, wearing eye protection for DIY, gardening and welding, using UV-blocking sunglasses or goggles in snow, treating dry eye and blepharitis, and taking any painful red eye to in-person care on the day it starts.
- Red eye: Clinical Knowledge Summary, NICE Clinical Knowledge Summaries, revised 2024.
- Corneal superficial injury: Clinical Knowledge Summary, NICE Clinical Knowledge Summaries, revised 2023.
- Blindness and vision impairment: fact sheet, WHO, World Health Organization, 2024.
- Herpes simplex virus: fact sheet, WHO, World Health Organization, 2025.
- Medical interventions for acanthamoeba keratitis (Cochrane Review), Cochrane, Cochrane Collaboration, 2015.
- Red eye, NHS, National Health Service (UK), accessed October 2026.
This page is for information only and is not a substitute for a medical consultation. Guideline links are provided for transparency; treatment decisions are made with your doctor.
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