A corneal ulcer is an open sore on the cornea, the clear, dome-shaped surface that covers the front of the eye. It is a potentially serious condition that requires prompt medical attention to prevent vision loss.
Causes and Risk Factors
Corneal ulcers can result from various causes, including:
Infections:
Bacterial: Often associated with contact lens use or eye injuries.
Viral: Commonly caused by herpes simplex virus (HSV) or varicella-zoster virus.
Fungal: Associated with injuries involving organic material or prolonged use of steroid eye drops.
Parasitic: Acanthamoeba infection is rare but can occur in contact lens wearers.
Eye Injuries: Scratches or foreign objects in the eye can lead to ulcers.
Dry Eye Syndrome: Severe dryness can damage the corneal surface and increase the risk of ulcers.
Contact Lens Misuse: Wearing lenses overnight or not cleaning them properly can introduce bacteria or fungi.
Underlying Eye Conditions: Conditions like severe allergic eye disease or eyelid disorders can predispose individuals to corneal ulcers.
Symptoms
Common symptoms of a corneal ulcer include:
Eye Pain: Often severe and persistent.
Redness: Surrounding the affected eye.
Tearing: Excessive tearing or discharge.
Blurry Vision: Vision may become hazy or obstructed.
Sensitivity to Light: Photophobia is common.
Foreign Body Sensation: A feeling that something is stuck in the eye.
White Spot on the Cornea: Visible with or without magnification.
Diagnosis
An eye doctor can diagnose a corneal ulcer through:
Slit-Lamp Examination: Using a special microscope to examine the cornea.
Fluorescein Staining: A dye test to highlight the ulcer.
Corneal Cultures: If an infection is suspected, a sample may be taken to identify the causative agent.
Treatment and Management
Treatment depends on the underlying cause but typically includes:
1. Antimicrobial Therapy
Antibiotics: Broad-spectrum or targeted drops for bacterial infections.
Antiviral Drops or Pills: For viral causes like HSV.
Antifungal Medications: For fungal infections.
Anti-Parasitic Treatment: For Acanthamoeba infections.
2. Supportive Care
Lubricating Eye Drops: To alleviate dryness and promote healing.
Pain Relief: Oral or topical medications to manage discomfort.
3. Surgical Intervention
Corneal Transplant: In severe cases where the ulcer has caused significant scarring or perforation, a corneal transplant may be necessary.
Prevention
To reduce the risk of corneal ulcers:
Practice Good Contact Lens Hygiene: Always clean lenses properly and avoid overnight wear unless prescribed.
Protect Your Eyes: Wear protective eyewear during activities that risk eye injury.
Treat Underlying Conditions: Address dry eyes, eyelid issues, or allergic eye disease promptly.
Avoid Touching Your Eyes: Keep hands clean and avoid rubbing your eyes.
Complications
If left untreated, corneal ulcers can lead to:
Corneal Scarring: Permanent vision impairment.
Perforation: A hole in the cornea that may require emergency surgery.
Vision Loss: Partial or complete loss of vision in the affected eye.
Secondary Infections: Spread of infection to other parts of the eye.
When to See a Doctor
Seek immediate medical attention if you experience:
Severe eye pain.
Sudden changes in vision.
Persistent redness or discharge.
Sensitivity to light that worsens.
Living with a Corneal Ulcer
Recovery from a corneal ulcer requires diligence in following medical advice and attending follow-up appointments. Early diagnosis and appropriate treatment are key to preventing complications and preserving vision.
