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Diffuse Lamellar Keratitis: Symptoms, Stages, Treatment, and Recurrence

Gina Walters


diffuse lamellar keratitis

Keratitis is an inflammatory eye condition that affects the cornea (the eye’s clear front surface).

It can occur due to different infections (viral, fungal, bacterial), injuries, or underlying conditions. 

A potential cause of this condition can be a complication that arises after refractive surgeries. This particular form of Keratitis is Diffuse Lamellar Keratitis (DLK). 

DLK is severe, requiring timely diagnosis and medical intervention to prevent potential vision issues.

This article discusses Diffuse Lamellar Keratitis, exploring its symptoms, stages of progression, treatment approaches, and potential for recurrence.

What is Diffuse Lamellar Keratitis

DLK is a specific type of Keratitis due to complications after eye surgery, such as LASIK or PRK. 

It causes inflammation of the area between the corneal flap and the stroma (the cornea’s middle layer) underneath.

The eyelid is divided into two lamellae, namely the anterior and posterior. Diffuse Lamellar Keratitis develops in the middle of the two lamellae, or the lamellar interface.

This complication can cause vision difficulties if left untreated.

LASIK: Also known as ‘laser-assisted in situ keratomileusis,’’ a laser eye procedure that helps treat several vision-related issues.
PRK: Photorefractive Keratectomy is a refractive surgery to treat vision problems, such as farsightedness, nearsightedness, or astigmatism.

Diffuse Lamellar Keratitis symptoms

Red eye (Risk Factor)Source: Alajsdfas
Red eye

Recognizing symptoms of DLK, such as eye pain, blurry vision, and redness, is essential for early detection and timely treatment. 

The following symptoms may indicate Diffuse Lamellar Keratitis and require prompt medical attention:

  • Blurry vision and decrease in visual clarity
  • Red eyes and swelling
  • Sensitivity to light (Photophobia)
  • Eye pain or discomfort 
  • Excessive tearing 
  • The sensation of a foreign body (such as grit or sand) in the eye 
  • Corneal haze or opacity

Recommended read: Do you suspect you have Keratitis? Learn about its signs and symptoms — Keratitis Symptoms: Understanding the Signs of Corneal Inflammation

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Stages of Diffuse Lamellar Keratitis

Diffuse Lamellar Keratitis (DLK) usually advances in stages or phases, ranging from minor inflammation to more severe cases. The stages include:

Stage 1 (mild): DLK begins as a mild inflammation in the area beneath the corneal flap. The inflammation may be subtle and not significantly affect vision.

Stage 2 (moderate): The inflammation becomes more visible, and symptoms such as impaired vision, light sensitivity, eye redness, or pain may occur. Inflammatory cells at the corneal interface could become more apparent.

Stage 3 (severe): The inflammation becomes more apparent at this stage, potentially causing significant discomfort, visual abnormalities, and corneal haziness or scarring. The effects on vision can impact daily activities. 

Stage 4 (advanced): This stage of DLK is the most severe, marked by intense inflammation, significant visual impairment, discomfort, and notable corneal opacity. Urgent medical attention is needed to prevent permanent vision damage.

Diffuse Lamellar Keratitis treatment

Use-eyedropSource: pixelshot
Use eyedrop (follow doctor’s advice)

Treatment for Diffuse Lamellar Keratitis aims to reduce inflammation, relieve symptoms, and prevent potential vision issues.

Doctors commonly prescribe Keratitis eye drops or ointments containing corticosteroids to minimize inflammation in the corneal surface.

In addition, anti-inflammatory medicines, such as Non-Steroidal Anti-inflammatory Drugs (NSAIDs), can help complement steroids. 

Additional treatments like oral medications or other strategies may be needed in severe cases based on the individual’s condition.

Recommended read: Learn how to fight Keratitis! Check out — Exploring Keratitis Treatment Options 

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Diffuse Lamellar Keratitis recurrence

The recurrence of DLK is possible after treatment. Identifying the risks and adhering to your doctor’s guidelines is critical to avoid recurrence.

Regular eye checkups are essential to monitor progress, examine the response to treatment, and adjust medication if necessary.

It is important to diligently follow the prescribed treatment regimen and attend follow-up checkups for proper management.  

Moreover, taking precautions and following postoperative guidelines can help avoid trauma and prevent the recurrence or worsening of DLK.

Any lingering or returning symptoms, even if mild, should not be ignored. Contact an eye care specialist promptly.

Key takeaways

Diffuse Lamellar Keratitis is a postoperative complication after eye procedures like LASIK and PRK.

It involves the inflammation of the interface beneath the corneal flap. It can lead to symptoms like blurry vision, redness, eye pain, and sensitivity to light

This condition demands attention as it gets progressively more severe with each stage, potentially causing vision complications in the advanced stages.

Recognizing symptoms is important for timely diagnosis and proper care. Eye specialists may prescribe topical steroids along with NSAIDs to reduce inflammation. 

Adhering to your doctor’s guidelines and completing the full course of treatment is necessary to avoid the recurrence of DLK. 

Follow your eye specialist’s postoperative care instructions to manage DLK and preserve eye health.

Frequently Asked Questions

How long does it take for DLK to resolve?

Diffuse Lamellar Keratitis (DLK) typically resolves within a few days to weeks with proper treatment, varying based on severity.

Is DLK curable?

Yes, DLK is treatable, especially if detected in the early stages. Prompt intervention and follow-up care can help get rid of this condition.

Is DLK serious?

Yes, DLK can be a serious postoperative complication if left untreated. It can potentially lead to vision complications in the advanced stages.

How common is DLK?

DLK is not common but can sometimes occur as a postoperative complication after refractive surgeries.

What is Diffuse Lamellar Keratitis vision like?

DLK can lead to blurred vision due to corneal inflammation, but it usually improves with treatment.

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