keratic

Keratic is an ophthalmology-related adjective derived from the word kerat- meaning cornea. It is most commonly encountered in the term keratic precipitate, which refers to inflammatory deposits on the corneal endothelium. These deposits appear as gray-white or yellowish spots on the posterior surface of the cornea and are indicators of intraocular inflammation.

Keratic precipitates (KPs) form when inflammatory cells and plasma proteins from the aqueous humor adhere to the endothelium. They vary in size, shape, and appearance. In granulomatous uveitis, KPs are often large and greasy or “mutton-fat” in appearance; in non-granulomatous uveitis, they tend to be smaller and more discrete. KPs can also be pigmented if iris pigment adheres to the endothelium. Gravity commonly causes KPs to settle toward the inferior cornea when the eye and body are upright.

Clinically, KPs are a sign of active intraocular inflammation and are usually assessed during slit-lamp examination alongside the anterior chamber reaction. Their presence and morphology can help guide diagnostic considerations and monitoring of disease activity in conditions such as uveitis and keratouveitis.

Diagnosis and management emphasize treating the underlying inflammatory process. Management often includes topical corticosteroids to reduce anterior segment inflammation, cycloplegic drops to relieve pain and prevent synechiae, and monitoring for side effects such as intraocular pressure elevation. In recurrent or chronic cases, systemic immunosuppression or biologic therapy may be indicated. Resolution of keratic precipitates generally accompanies improvement in inflammation and vision.