Filamentary Keratitis

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  • Formation of strands/filaments from degenerated epithelial cells and mucus, adhering to the epithelium


  • Severe dry eye (most common)
    • Underlying conditions? (Sjögren, rheumatoid arthritis, etc.)
  • Overuse of contact lenses
  • Instability of the corneal epithelium
  • Keratoconjunctivitis of the upper limbus
  • Bullous keratopathy
  • Neurotrophic keratopathy
  • Prolonged or frequent eye closure


  • Moisturizing eye drops (e.g. Lacrycon)
  • Mucolytic eye drops; e.g., Acetylcysteine gtt 5% or 10% 4x/day
  • NSAIDs gtt, e.g., Diclofenac gtt
  • Mechanical removal of filaments
  • Therapeutic contact lens
  • Treat underlying condition (if present)


  • EyeWiki Filamentary Keratitis
  • The Wills Eye Manual: Office and Emergency Room Diagnosis and Treatment of Eye Disease; Nika Bagheri MD, Brynn Wajda MD, et al; Lippincott Williams&Wilkins; 7th Edition (2016)
  • Kanski’s Clinical Ophthalmology: A Systematic Approach; Jack J. Kanski MD, Brad Bowling MD; Saunders Ltd.; 8th Edition (2015)