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Bob Costas sidelined again: Could it be keratitis?

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Bob Costas has asked Matt Lauer of NBC's Today show to fill in for him at the Olympic Games in Sochi, Russia, for the second time, due to an unnamed eye infection. When Costas called his colleagues on the set in Sochi to discuss his illness, he told them, "Actually, I don't feel that bad [...] In this case, it's just involuntary. It's an eye infection, and my eyes are so blurry and watery and they're constantly tearing up [...] It's just not possible to be in the studio." Costas indicated that he has come to work on occasions when he has felt worse; he contrasted those occasions with this one, in which his eye infection is actually disabling him to the point where he cannot do his job.

The appearance of Costas's eyes prior to his two days off, as well as the decision to ask Lauer to step in, has prompted concerned viewers to wonder about the nature of his ailment. Although NBC has not issued an official statement, Costas himself told the New York Times, "You hear it called pinkeye or conjunctivitis." The Times also reported that Costas is taking antibiotics to treat the infection.

However, Costas's symptoms also appear to match those of keratitis, or corneal inflammation. Keratitis manifests itself with redness and pain of the affected eye(s), as well as excess tears and / or discharge, difficulty opening the affected eye(s), blurred vision, and sensitivity to light -- all of which symptoms Costas has said that he has. According to the Mayo Clinic, infectious keratitis can result from contaminated contact lenses -- Costas is a contact lens wearer, although since developing the infection, he has switched to wearing glasses -- or even direct contamination (by water) of a cornea that has been scratched by a contact lens.

"Chemicals in water such as those used in swimming pools may irritate the cornea and cause irritation and a physical breakdown of the [...] corneal epithelium," the Mayo Clinic explains. Then, a contaminating agent can take hold and infect the already-injured eye: "Bacteria, fungi, and parasites in water -- particularly in oceans, rivers, lakes, and hot tubs -- can enter your eyes when you're swimming or bathing and result in keratitis."

Most types of infectious keratitis can be treated with eye drops and / or oral medication, according to the Mayo Clinic. Bacterial keratitis is treated with antibiotics, fungal keratitis is treated with antifungal medications, and viral keratitis is treated with antiviral drugs. However, one type of infectious keratitis, known as acanthamoeba keratitis and caused by a parasite, is notoriously difficult to treat. Although antibiotic eye drops may help, in some cases, the damage from the parasite is so severe that a corneal transplant is necessary.

The Mayo Clinic has these final words on preventing keratitis:

  • Don't sleep with contact lenses in your eyes;
  • Completely replace your contact lens solution on a daily basis, and replace your lens case every three to six months;
  • Don't wear your contact lenses while swimming;
  • "Wash, rinse, and dry" your hands completely before handling your contacts.

Mothers everywhere would likely add, "Don't touch your eyes or rub your eyes."

Whether Costas's infection is conjunctivitis, keratitis, or both, his many fans wish him a speedy recovery with no lasting damage to his eyes.

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