Corneal Ulcer: A corneal ulcer is an open sore or epithelial defect on the cornea. The cornea overlies the iris, which is the colored part of the eye. A corneal ulcer typically occurs as a painful, red eye, with mild to severe eye discharge and reduced vision. A corneal ulcer will usually seem like a gray to a white opaque or translucent area on the cornea.
Some corneal ulcers may be too little to see without sufficient magnification and illumination.
Causes of Corneal Ulcer
- Most corneal ulcers are caused by infections. Bacterial infections cause corneal ulcers and are common in contact lens wearers.
- Fungal infections can cause corneal ulcers and may occur with improper care of contact lenses. Parasites like Acanthamoeba may also cause corneal ulcers.
- Viruses that may create corneal ulcers include the herpes virus and the Varicella virus.
- Tiny cuts or scratches on the corneal surface may become infected and lead to corneal ulcers. Such injuries damage the corneal surface and make it easier for bacteria to invade and cause a corneal ulcer.
- Dry eyes (keratitis sicca) can aggravate corneal ulcers.
- Bell’s palsy, can dry the eye as well as the cornea and make it more vulnerable to ulcers. Any condition which makes the loss of sensation of the corneal surface may enhance the risk of corneal ulceration.
- Chemical burns into the eye can injure the cornea of the eye and commence to corneal ulceration.
- Patients with immunological disorders ( rheumatoid arthritis, lupus, and others) may also develop corneal ulcers.
- Wearing lenses for extended periods of time can also block oxygen to the cornea, making it more susceptible to infections.
Corneal Ulcer Symptoms
There may be an increase in pain when looking at bright lights(photophobia).A white or gray round spot on the cornea that is visible to the naked eye if the ulcer is large.
Diagnosis of Corneal Ulcer
Your eye specialist will use a special dye called fluorescein to light up any damage to the cornea, also examine your cornea using a microscope called a slit lamp.
The slit-lamp exam will enable to see the damage of the cornea and determine if you have a corneal ulcer. Scrapings of the ulcer may be conducted to the laboratory for identification of bacteria, fungi, or viruses.
Treatment of Corneal Ulcer
Infection is a common occurrence in corneal ulcers. Antibiotic, antifungal or antiviral eye drops are the treatments of choice.
Your eye specialist may prescribe steroid or anti-inflammatory eye drops after the infection has improved or is gone. This should diminish swelling and help inhibit scarring. Steroid eye drop use is controversial for the corneal ulcer. It is likely that steroid eye drops may worsen an infection.
Your ophthalmologist may prescribe oral pain medications to control the pain. Pain can also be controlled with special eye drops that keep your pupil dilated.
If corneal ulcers cannot be treated with medication, you may require corneal transplant surgery to keep your vision. Corneal transplantation can replace the injured cornea with a healthy donor cornea to rebuild vision.