Corneal Ulcers

July 24, 2013

A corneal ulcer is a severe condition which requires IMMEDIATE treatment from your eye care provider. Untreated (and, unfortunately, even with treatment), corneal ulcers can permanently scar the eye, rob vision, and can even cause loss of the eye itself. If a concern for a corneal ulcer is raised, through your primary doctor, acquaintance, or even by self estimation, evaluation and treatment by an eye care professional is essential to treating the condition and providing you the best prognosis available.

What is a corneal ulcer?

Corneal ulcers are inflammatory or infective conditions of the cornea. They are often caused by bacterial infection following contact lens overuse or misuse, eye injury or trauma, severe dry eye, chlamydia infection (trachoma), or herpetic eye infections; they may also be caused by viral infection, fungi, or parasitic infection of acanthamoeba (parasite found in tap water, swimming pools, hot tubs, and other bodies of water).  Ulcers may occur in any portion of the cornea (the clear cap of the eye); they can be much more vision-threatening, however, when they occur in the central cornea, often over the pupil.

Symptoms of a corneal ulcer include, but are not limited to:

  • Blurry/hazy vision
  • A red or bloodshot eye
  • A visible white or discolored spot on the eye.
  • Sensitivity to light
  • Itching and discharge
  • Painful eyes
  • Tearing

 

How can I avoid corneal ulcers?

When your optometrist, ophthalmologist, optician, or primary doctor tell you not to sleep in your contacts, they mean it!! Contact lenses are a very common cause of corneal ulcers; sleeping in contacts, poor contact hygiene, and over-wearing contact lenses are habits which can lead to this very severe, possibly vision-destroying condition. Extended wear contacts (those that are approved for overnight wear) still need to be taken out on occasion; if you can tolerate “daily wear” lenses (lenses which you use only once and discard afterwards) provide less risk of complications from over-wear, provided you adhere to the restrictions given on the lenses.

How are corneal ulcers treated?

Treatment depends on the severity of the ulcer. Topical antibiotics are usually advised and the area may be cultured for evaluation; follow-up appointments range depending on the aggressiveness of the ulcer, some specialists may recommend daily follow-ups, while others may suggest visits every other day or every three days. Unfortunately, severe corneal ulcers, even with treatment, may lead to permanent corneal scarring. While immediacy in treatment gives the best chance for avoiding severe complications from ulcers, ulcers may still cause severe and sometimes irreparable damages. Even with the best care and management of this condition, some patients with corneal ulcers may require a corneal transplant to achieve any amount of vision after this severe infection. Corneal transplants, while a very significant and serious surgical treatment, can be very effective in allowing compromised eyes to regain some semblance of usefulness; transplants replace affected corneas with healthy, cadaver donations.