Corneal Ulcer

What is a corneal ulcer?

A corneal ulcer is a breakdown of the cornea (the clear outer layer of the eye) usually because of an infection. The cornea, which is usually clear, becomes inflamed and cloudy, causing your vision to become blurry. If not treated right away, the cornea can become dangerously thin, become scarred, and lead to blindness.

How does it occur?

Corneal ulcers are usually caused by infection. Anything that causes tiny breaks in your cornea can put you at risk for infection. This includes:

• contact lens use
• physical injury
• severely dry eyes
• problems with closing your eyelid
• chemical injury or exposure

Other conditions can cause corneal ulcers without infection. These include:

• auto-immune conditions (when the body makes antibodies against part of itself)
• conditions that cause the cornea to lose feeling

What are the symptoms?

Symptoms of a corneal ulcer include:

• pain or gritty feeling
• tearing
• discharge from the eye
• cloudy vision
• light sensitivity (photophobia)
• red, irritated eye

How is it diagnosed?

Your healthcare provider will ask about your symptoms, examine your eyes, and do tests to find the cause. Tests you may have are:

• an exam using a special microscope (a slit lamp) to look closely at your cornea
• an exam with drops and special lenses to look into the back of your eye (a dilated exam)
• tests of your cornea to look for the specific cause of the infection under a microscope
• an ultrasound test to look at the back of your eye if you have a severe infection
• blood tests if your healthcare provider thinks your corneal ulcer may be related to a medical condition

How is it treated?

A corneal ulcer is a severe condition that requires immediate medical attention. Depending on the cause of your infection, frequent use of different eyedrops and/or ointment may be necessary, as often as every hour and sometimes overnight as well. In addition, you might be given eyedrops to help with pain. Once the ulcer begins to improve, your healthcare provider may decide to add a steroid drop to try to lessen scarring of the cornea.

Most corneal ulcers get better with treatment. Sometimes, the ulcer causes the cornea to become so thin that a hole develops. This is an emergency that usually requires surgery to treat.

How long will the effects last?

If not treated right away, a corneal ulcer can lead to blindness. The treatment of a corneal ulcer will require frequent trips to your eye healthcare provider to make sure that the ulcer is responding to the medications you are using. Severe corneal ulcers can cause a permanent scar even after successful treatment. If this scar affects you vision, your healthcare provider may recommend several possible treatments, including contact lenses, laser treatment, or surgery.

How can I take care of myself?

• If you have any of the risk factors and have any of the symptoms listed above, you should contact your healthcare provider right away.
• If you are given drops to use, be sure to follow your healthcare provider's instructions carefully and keep all of your follow up appointments.

How can I prevent a corneal ulcer?

• If you wear contact lenses, wash your hands before handling them, clean your contacts as instructed and do not sleep in your lenses.
• If you work in a place where things may get into your eye, be sure to wear goggles at all times.

Reviewed for medical accuracy by faculty at the Wilmer Eye Institute at Johns Hopkins. Web site: http://www.hopkinsmedicine.org/wilmer/

Written by Dr. Daniel Garibaldi.
Published by RelayHealth.
© 2009 RelayHealth and/or its affiliates. All Rights Reserved.