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Corneal Ulcers: An Overview

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Updated June 09, 2012

Corneal Ulcer:

A corneal ulcer is an erosion or open sore on the surface of the cornea. The cornea is the transparent area at the front part of the eye that serves as a window through which we see. It also refracts light and offers protection to other parts of the eye. If the cornea becomes inflamed due to infection or injury, an ulcer may develop. A corneal ulcer is a serious condition that must be treated promptly to avoid lasting vision problems. Although good medicines are available for treatment, corneal ulcers can cause severe loss of vision and even blindness.

Causes of Corneal Ulcer:

Corneal ulcers are most commonly caused by germs. Although the human eye is well-protected by the eyelid and abundant tears, germs and bacteria may be able to enter the cornea through small abrasions if it is damaged. Corneal ulcers are common in people who wear contact lenses, especially if they wear them overnight. Generally, the deeper the cornea ulcer, the more serious the condition becomes. A very deep ulcer can cause scarring on the cornea, blocking light from entering the eye.

Common causes of corneal ulcers:

  • Bacteria
  • Viruses
  • Injury
  • Severe allergic disease
  • Fungi
  • Amoebas
  • Inadequate eyelid closure

Symptoms of Corneal Ulcer:

Symptoms of a corneal ulcer are usually obvious, especially if the ulcer is deep. Because the cornea is very sensitive, corneal ulcers tend to produce severe pain. Vision is sometimes impaired, and the eye may be tearing and red. It may also hurt to look at bright lights. If you have any of the following symptoms, you should be checked by an eye doctor right away:
  • Redness
  • Pain
  • Tearing
  • Discharge
  • White spot on the cornea
  • Blurry vision
  • Burning
  • Itching
  • Light sensitivity

Diagnosis:

Early diagnosis is important in treating corneal ulcers. Your doctor will ask questions to determine the cause of the ulcer. Your eyes will need to be examined under a bio-microscope, called a slit lamp. A special dye may be placed in your eye to aid in the diagnosis. If it is not clear what the exact cause is, your doctor may culture the ulcer in order to properly treat it. After numbing your eye with special eye drops, cells may be gently scraped from the corneal surface so that they can be tested.

Treatment of Corneal Ulcer:

Treatment for corneal ulcers needs to be aggressive, as some ulcers lead to vision loss and blindness. Treatment usually involves antibiotics as well as antiviral or antifungal medications. Steroid eye drops may also be given to reduce inflammation. Some doctors prescribe topical eye drops to be inserted several times per day until the ulcer is completely healed. In severe cases, patients are hospitalized so that the correct treatment is given. If infections are stubborn or leave a scar, a corneal transplant may be needed to restore vision. If treatment is not given, blindness or even total loss of the eye can occur.

Source:

Catania, Louis J. "Primary Care of the Anterior Segment." Second Edition, Copyright 1995.

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