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Corneal Ulcer - Causes, Symptoms, Diagnosis, and Treatment

Published on Mar 08, 2022 and last reviewed on Mar 16, 2022   -  5 min read

Abstract

When not treated promptly, corneal ulcers can permanently affect your vision and result in blindness. Read on to know how you can manage and prevent one.

Contents

What Is the Cornea?

The see-through layer that covers the front portion of the eyes is called the cornea. It covers the eye's center opening (pupil), the colored part of the eyeball (iris), and the fluid-filled anterior chamber of the eye. It serves as the window through which you see. The cornea bends the incoming light onto the lens and protects the other parts of the eye.

What Is the Meaning of a Corneal Ulcer?

An open sore or defect in the corneal epithelium, along with inflammation, is a corneal ulcer. Injury or infection of the eye can result in inflammation of the cornea, increasing the risk of an ulcer. Apart from physical injury and infection, chemical injury, eye dryness, and contact lens misuse can also result in corneal ulcers. If not treated promptly with medicines, it can permanently affect your vision and result in severe loss of vision or blindness. Most cases of corneal ulcers improve without affecting the vision to a greater extent.

What Are the Symptoms of Corneal Ulcers?

Before signs of corneal ulcers develop, most people notice signs of an infection. The symptoms of an eye infection are:

  1. Itchy eyes.

  2. Burning sensation in the eyes.

  3. Sensitivity to light.

  4. Eye redness.

  5. Watery eyes.

  6. Pink eye.

  7. Pus discharge from the eyes.

In addition to these symptoms, the other signs and symptoms of corneal ulcer are:

  1. Swollen eyes.

  2. Eye pain.

  3. Severe tearing.

  4. Blurry vision.

  5. Grayish-white spot on the cornea.

  6. Eyelid swelling.

  7. Foreign body sensation in the eye.

  8. Inability to open the eye.

These symptoms are severe and need immediate treatment to prevent vision loss. Bigger corneal ulcers look like grayish-white spots on the cornea, while the smaller ones cannot be seen without magnification.

How Does a Corneal Ulcer Develop?

The following causes can result in the development of a corneal ulcer:

1) Infectious Causes:

2) Non-Infectious Causes:

How Does a Doctor Diagnose a Corneal Ulcer?

The ophthalmologist will examine your eye to diagnose corneal ulcers. They might use a test called fluorescein eye stain. Here, the doctor will drop an orange dye onto a blotting paper. By touching this blotting paper to your eye lightly, the doctor will transfer the dye into your eye. After this, the doctor will shine a violet light onto your eye with the help of a microscope called a slit-lamp to look for corneal ulcers. If there is any damage to the corneal surface, it will appear green under the violet light.

To know if infectious agents caused the corneal ulcer, the eye doctor will gently take a sample by scraping the ulcer after putting eye drops. The sample is then tested for the presence of bacteria, viruses, or fungi.

How Are Corneal Ulcers Treated?

As these ulcers can lead to some amount of vision loss or blindness, treatment has to be prompt and aggressive. The treatment options include:

1) For Non-Infectious Causes - If the symptoms are mild, then the doctor might only prescribe artificial teardrops. In severe cases, an eye patch and topical eye drops are prescribed. This includes steroid eye drops to reduce inflammation. You might also have to take Vitamin C supplements to reduce corneal scarring. An ulcer usually heals within a week. If not, the doctor will place an amniotic membrane on the cornea for a week.

2) For Infectious Causes -

3) Cornea Transplant - If the ulcer does not heal with medications, or if vision gets impaired, the doctor might suggest a cornea transplant. Here, the corneal tissue is removed and replaced with donor tissue.

How to Prevent Corneal Ulcers?

As contact lens users are more prone to corneal ulcers, one should disinfect and use the lens properly. The following tips might help prevent corneal ulcers:

  1. Daily-wear contacts are better.

  2. Do not forget to take the lenses out before going to sleep.

  3. Remember to wash your hands before touching your contact lenses.

  4. Handle your lens gently while cleaning them. Rub them gently with a cleaning solution to avoid scratching them.

  5. Replace your contact lenses and contact lens case as recommended.

  6. The leftover contact lens solution should be discarded each time you disinfect the lenses.

  7. Avoid wearing contact lenses while swimming.

Conclusion:

Never underestimate or ignore eye problems. Ignoring them in the earlier stages can lead to irreversible complications, after which vision loss becomes permanent or difficult to function as before. If you are suffering from symptoms of corneal ulcer, consult an ophthalmologist online now.

Frequently Asked Questions


1.

What Does a Corneal Ulcer Look Like?

A normal cornea looks clear and transparent. A corneal ulcer will often appear gray to white and opaque or transparent. It is an open sore in the cornea. Some of the corneal ulcers are very small and require adequate magnification and illumination. They cause blurry vision, pain, and swollen eyelids.

2.

How Long Does a Corneal Ulcer Take To Heal?

Most simple, uncomplicated ulcers heal within a week or by a maximum of two to three weeks. But an infected or complicated ulcer can take several weeks to heal.

3.

What Is the Etiology of a Corneal Ulcer?

- Bacterial Infections.

- Viral infections such as herpes simplex virus or varicella virus.

- Fungal infections.

- Parasitic infections.

- Severe allergic conditions.

- Inadequate eye closure.

4.

What Is the Treatment for Corneal Ulcers?

Treatment involves antibiotics and some antiviral or antifungal medications. In addition, steroid eye drops can help reduce inflammation and be used several times a day until the ulcer heals completely. Supplements like Vitamin C can also be given to lessen corneal scarring.

Corneal ulcer needs to be treated aggressively. If it is not healing normally with typical treatment, an amniotic membrane will be placed on the cornea for seven to 10 days. A corneal transplant is needed to restore the lost vision if permanent scarring occurs.

5.

Is Corneal Ulcer Painful?

Corneal ulcers cause redness and severe pain. It gives the feeling that something is there in the eye and increased tear production. In addition, the pain increases when looking at bright lights.

6.

Should Corneal Ulcers Be Treated Immediately?

Corneal ulcers are common and occur at any age. They need immediate attention as they may spread to other eye areas and cause complications such as scarring, cataracts, or glaucoma. However, it can be resolved within two or three weeks in uncomplicated cases.

7.

Will Drinking More Water and Staying Hydrated Help Corneal Ulcers?

Even though corneal ulcers are commonly due to corneal trauma followed by infection, dryness can also cause a corneal ulcer. They also affect the course of healing. Drinking more water can increase the secretion of tears which is essential to prevent the eyes from drying.

8.

What Are the Signs of Recovery in Corneal Ulcer?

When treated inadequately or without any treatment, corneal ulcers may result in loss of vision or blindness. We can tell if the corneal ulcer is healing by specific evidence like the healing of the ulcer, especially in the periphery and when the infiltrate size is getting smaller. We must watch for about a week after stopping antibiotics from making sure the cornea remains clear.

9.

What Are the Home Remedies for Corneal Ulcers?

- You must remove the contact lenses that you are wearing.

- Apply cool compresses over the affected eye.

- Do not touch or rub the eyes with your fingers.

- You should avoid spreading the infection by washing your hands often and drying them with a clean towel.

- Over-the-counter pain medications can be taken. However, an early evaluation and treatment with an ophthalmologist are necessary if a corneal ulcer is even suspected.

10.

Which Bacteria Is Responsible for Corneal Ulcers?

Staphylococcus aureus, Streptococcus pneumoniae, and Pseudomonas species are responsible for 80 % of corneal ulcers. Pseudomonas aeruginosa is most commonly responsible for corneal perforation. It can cause a perforation within 72 hours.

Last reviewed at:
16 Mar 2022  -  5 min read

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