Sight under siege: understanding corneal infections and ocular health

Infectious keratitis (IK) remains a significant global cause of visual impairment and blindness, despite the availability of advanced treatment options. In the Netherlands and other Western countries, contact lens (CL) wear is the leading cause of IK. Conversely, in developing regions, trauma accounts for a substantial number of approximately 6 million reported corneal ulcers reported annually. Accurate identification of the causative microorganism is crucial for targeted therapy, as prompt eradication is necessary to prevent corneal destruction and vision loss resulting from microbial infiltration and the associated inflammatory response. However, diagnosing IK poses challenges due to non-specific clinical symptoms, and current diagnostic methods have inherent limitations. Culture-based techniques are time-consuming and lack sensitivity, while microbe-specific molecular tests cannot distinguish between viable and non-viable microorganisms and only detect a limited number of known microorganisms associated with IK. In this thesis various aspects are studied to improve diagnosis and treatment of IK.