CORNEAL ULCER

Beginners_Figure_1.jpg

Normal Eye

Corneal Ulcer

Image courtesy of American Academy of Opthalmology

wHAT IS CORNEA?

The cornea is the transparent dome at the front of the eye through which the iris (the coloured part of the eye) and the pupil (the black hole in the centre of the eye) can be seen. The cornea is responsible for most of the focusing power of the eye. It has to be clear, smooth and regularly-shaped in order for you to see clearly. If your cornea is deformed, damaged, hazy or scarred, you will have problems seeing.

Image courtesy of NIH National Eye Institute

what is corneal ulcer?

A corneal ulcer is an erosion or open sore in the outer layer of the cornea. It is often the result of a localized infection, similar to an abscess. It can be caused by a variety of things including viruses, bacteria or fungi. Sometimes it can also be a result of some types of underlying illnesses which either cause very severe dryness or auto-immune ulcers (your own immune system affecting the cornea). 

 

Things that may put you at increased risk of a corneal ulcer include: 

 

  • Foreign bodies in the eye

  • Contact-lens overuse (this includes sleeping in contact lenses which are not meant for this)

  • Scratches (abrasions) on the eye surface

  • Severely dry eyes

  • Severe allergic eye disease

  • Eyelids that do not close all the way, such as with Bell's palsy

  • Various inflammatory disorders

what are the symptoms of corneal ulcer?

These may include all or some of the following:

 

  • a swollen eyelid

  • redness

  • pain or discomfort in the eye (the severity varies)

  • pain when looking into bright light

  • watering eyes

  • blurred eyesight

  • a white patch seen on the cornea

examinations and tests

If you are suspected to have a corneal ulcer you should be referred immediately to an ophthalmologist (eye doctor) who will do some of these tests on you: 

 

  • Visual acuity

  • Slit-lamp (microscope) examination with fluorescein dye

  • Swab of the eye or

  • Scrapings from the cornea to look for bacteria

treatment

The treatment of a corneal ulcer depends very much on the suspected cause of the ulcer. The treatment is then targeted against this and may include eye drops and sometimes tablets. Severe ulcers can sometimes lead to scarring and if this happens to be in the centre of the cornea it can permanently affect your vision. Sometimes the only way of getting rid of the scar is to perform a corneal transplant. 

 

When treament is initiated, your doctor may advise you to: 

 

  • Avoid eye make-up

  • Not to wear contact lenses at all for a prolonged period

  • Wear sunglasses or protective glasses

  • Admitted as an in-patient if intensive eyedrops are required

prevention

Getting treated for an eye infection by an ophthalmologist right away may prevent ulcers from forming. Wash hands and pay very close attention to cleanliness while handling contact lenses. Avoid wearing contact lenses overnight or swimming in them. Prescription swimming goggles are widely available and are far safer for your eyes.