The cornea is the clear (transparent) tissue at the front of the eye. A corneal ulcer is an erosion or open sore in the outer layer of the cornea. It is often caused by infection.
Causes
Corneal ulcers are most commonly caused by an infection with bacteria, viruses, fungi, or a parasite.
Acanthamoeba keratitis occurs in contact lens users, especially in people who make their own homemade cleaning solutions
Fungal keratitis can occur after a corneal injury involving plant material, or in people with a suppressed immune system
Herpes simplex keratitis is a serious viral infection. It may cause repeated attacks that are triggered by stress, exposure to sunlight, or any condition that impairs the immune system
Corneal ulcers or infections may also be caused by:
Eyelids that do not close all the way, such as with Bell’s palsy
Foreign bodies in the eye
Scratches (abrasions) on the eye surface
Severely dry eyes
Severe allergic eye disease
Various inflammatory disorders
Contact lens wear, especially soft contact lenses worn overnight, may cause a corneal ulcer
Symptoms
Symptoms of infection or ulcers of the cornea include:
Blurry or hazy vision
Eye that appears red or bloodshot
Itching and discharge
Sensitivity to light (photophobia)
Very painful and watery eyes
White patch on the cornea
Exams and Tests
Examination of scrapings from the ulcer
Examination under the eyelids
Fluorescein stain of the cornea
Pupillary reflex response
Slit-lamp examination
Tests for dry eye
Visual acuity
Blood tests to check for inflammatory disorders may also be needed
Treatment
Treatment for corneal ulcers and infections depends on the cause. Treatment should be started as soon as possible to prevent scarring of the cornea and long-term complications.
If the exact cause is not known, patients may be given antibiotic drops that work against many kinds of bacteria.
Once the exact cause is known, drops that treat bacteria, herpes, other viruses, or a fungus are prescribed. Severe ulcers sometimes require a corneal transplant.
Corticosteroid eye drops may be used to reduce swelling and inflammation in certain conditions.
Your eye doctor may also recommend that you:
Avoid eye makeup
Don’t wear contact lenses at all, or don’t wear them at night
Take pain medications
Wear an eye patch to keep out light and help with symptoms
Wear protective glasses
Outlook (Prognosis)
Many people recover completely from corneal ulcers or infections, or they have only a minor change in vision. However, a corneal ulcer or infection can cause long-term damage to the cornea and affect vision.
Possible Complications
Untreated corneal ulcers and infections may lead to:
