Corneal Ulcer

Last reviewed by Dr.Mary on August 7th, 2018.

What is a Corneal Ulcer?

This is an open lesion on the cornea which is the thin clear structure overlying the iris and is the colored portion of the eye. A corneal ulcer normally develops when the corneal surface is compromised or damaged in some way. Ulcers can be sterile meaning “not infected” by any bacteria or they can be infectious.


Corneal Ulcer Symptoms

The symptoms of most corneal ulcer are normally very obvious, especially in those cases where the ulcer is deep. Since the cornea is very sensitive, corneal ulcers tend to create very severe pain. The vision in the eye is often impaired and the eye may tear up and be read. It also might hurt to look at any bright lights.

Symptoms which are connected with corneal ulcers are contingent on if the ulcer is infectious or non-infectious, as well as the assertiveness of any organism that might be infecting the eye:

  • Severe pain – but not in all cases
  • Red eye
  • Tearing
  • Feeling as if something is in the eye
  • Blurry vision
  • Swollen eyelids
  • Thick discharge or pus draining from the eye
  • Sensitivity to light
  • White spot on cornea – depending on the severity of the ulcer – not always visible to the naked eye

Corneal Ulcer Causes

Ulcers on the cornea are in most cases the results of bacteria. The eye is actually protected by the lid of the eye as well as tears but bacteria and germs can still be able to gain entry to the cornea thru small lesions when damaged. Ulcers of the cornea are frequent in those individuals who are contact lens wearers, particularly those who wear them to bed. Normally, the deeper an ulcer is, the worse the problem has become. An ulcer which is very deep can create scarring which blocks light from entering the eye.

Common reasons for corneal ulcers:

1. The majority of ulcers are created by infections

  • Bacterial infections can create ulcers frequently with those who are contact lens wearers
  • Viral infections can also create ulcers. These include the varicella virus as well as herpes simplex virus
  • Fungal infections also can cause ulcers and can grow with inappropriate upkeep of contact lenses or abusing eyedrops having steroids

2. Tiny tears in the surface of the cornea can become infected leading to ulcers. These tears may come from injuries caused by scratches from glass particles in the eye, or metallic particles also. These damages to surface make it easy for any bacteria to enter and create an ulcer.

3. Any conditions that cause dry eyes and leave the eye without the normal protection of tears against germs and therefore can cause ulcers
4. Any conditions that causes problems or prevents the eyelids from closing totally, such as Bell’s palsy. This can dry the cornea and can make it susceptible to ulcers.
5. Condition causing loss of feeling to the corneal surface can escalate the likelihood of corneal ulceration.
6. Chemical burns or other damaging solutions that get in the eye causing injury to the cornea and lead to ulceration.
7. Wearing contact lenses can cause an increased possibility of ulcers:

  • Scratches around the edges of the lenses can scrape cornea making it susceptible to bacterial infections
  • Tiny bits of dirt stuck under the lenses can scratch the cornea
  • Bacteria from inadequately cleaned lens. If left on lenses for long periods, bacteria grow and damage the cornea.
  • Lenses worn for lengthy periods of time can block oxygen from getting to the cornea, making it more vulnerable to infections.

Corneal Ulcer Diagnosis

The physician will first take a complete patient history which can possibly indicate a trauma to the eye. Next if an ulcer is suspected, the physician will do a careful exam using a “slit lamp microscope”. Distinctive kind of drops which contain a dye for instance fluorescein can be installed to high light any ulcer making it easier to examine.

The physician can also do a culture if an infection is suspected. Once having numbed the eye by eye drops, the physician can scrape some cells very gently from the surface of the cornea and then tested to define the organism causing the infection.

Corneal Ulcer Treatment

The course of treatment will depend on whether the ulcer is sterile or infectious. Ulcers that are sterile normally will be treated by the reduction of eye inflammation reaction with, anti-inflammatory drugs, steroid drops and antibiotics.

Treatment for infectious ulcers which are not severe include medication with either an antibacterial, antiviral or antifungal medication, Eye drops which are steroids can be given to lessen any inflammation. Some physicians may prescribe some topical drops for insertion several times daily until the ulcer is totally healed.

Serious bacterial ulcers require treatment which is very aggressive. In a few cases, antibacterial eye drops will be used 4 times each hour. Steroid eye drops are not used in cases of severe infectious ulcers. And in some very severe cases, the patient may require being in the hospital so they can be given antibiotics by IV as well as therapy around the clock.

Corneal Ulcer Prevention

An individual should seek medical assistance directly for whichever symptoms of eye problems. Even minor injuries to the cornea can lead to an ulcer and can create consequences which are devastating, including loss of the eye or blindness.

Precautions that should always be taken with contact lenses:

  • Wear eye safety glasses when being exposed to any small particles
  • Avoid chemical irritation of the eye
  • If you have dry eyes or eyelids do not completely close, use artificial teardrops frequently

If you are a contact lens wear, be particularly careful about cleaning your lenses

  • Wash your hands every time before handling the lenses
  • Do not use saliva for lubricating lenses because of bacteria in your mouth
  • Remove lenses every evening to clean them
  • Never use only water to wash lenses
  • Never sleep in lens
  • Store lenses overnight in disinfecting solution
  • Remove lenses whenever eyes feel irritated and leave lenses out until eyes get better
  • Keep the lens case sterile

Corneal Ulcer Pictures

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