Corneal Ulcer
Date issued: January 2024
Review date: January 2026
C-547/MS/Ophthalmology/Corneal ulcer v2
PDF: Corneal Ulcer final January 2024 v2.pdf [pdf] 131KB
Corneal Ulcer
A corneal ulcer is a non-penetrating erosion or an open sore in the outer layer of the cornea, (the clear ‘window’ of the eye). This happens when the surface is damaged or compromised in some way.
Ulcers may be sterile (no infection) or infectious.
There are many causes for corneal ulcers but soft contact lens wearers have an increased risk if they do not stick to the strict routine for hygiene and wear.
Patients with severe dry eyes, blepharitis, corneal injuries and abrasions, inflammatory diseases,
or viral infections such as; herpes simplex (cold sores), are at an increased risk for corneal ulcer formation.
Signs and Symptoms
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Red eye
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Moderate to severe pain (not all cases)
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Watering
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Light sensitivity
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Discharge
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Pricking sensation
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White spot on the cornea (depending on the severity)
Detection and Diagnosis
Corneal ulcers are diagnosed with a careful examination using a slit lamp microscope. Special eye drops containing dye called fluorescein may be instilled in your eye to show the ulcer, making it easier to detect.
If an infection is suspected, the doctor may take swabs and send to the laboratory. This is done following instillation of anaesthetic eye drops to numb the surface of the eye. Cells are gently scraped from the corneal surface and tested to show the type of infection.
Treatment
This depends on the cause. Prompt treatment is essential to prevent further injury to the cornea.
Bacterial or fungal (infected) ulcers require aggressive treatment. In some cases, antibacterial eye drops are used every 15 minutes. Antiviral or antifungal eye drops are prescribed as soon as the infection is identified.
Non-infectious (sterile) ulcers are treated by reducing the eye’s inflammation with anti-inflammatory drops, frequent lubrication and antibiotics.
Expectations
Ulcers usually respond to treatment with good visual outcome in most cases.
Untreated, a corneal ulcer or infection can permanently damage the cornea. An uncommon complication is the perforation of the eye, resulting in spread of the infection inside the eye, and therefore, increasing the risk of permanent visual impairment.
Complications
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Corneal scarring
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Severe vision loss
Prevention
Wash hands and pay rigorous attention to lid hygiene, cleanliness while handling contact lenses, and avoid wearing lenses at night and prolonged usage.
Prompt early attention by an Ophthalmologist (Eye Doctor), to the early stage of the condition to prevent complications.
