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Corneal Ulcer |
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A corneal ulcer is an open sore on the cornea, the thin, coloured dome portion of the eye responsible for the refraction of light rays.
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Causes:
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- Most corneal ulcers are caused by infections. They are common in contact lens wearers and usually caused by bacteria. Viruses such as herpes simplex virus (causes cold sores) or the varicella virus (causes chickenpox and shingles). Fungal infections can cause corneal ulcers and are common after injuries mainly agricultural and with overuse of drops containing steroids.
- Scratches or abrasions due to trauma or foreign bodies on the cornea may also cause corneal ulcers by making it easier for bacteria and other bugs to cause ulcers.
- Dry eyes are also susceptible for corneal ulcers due to lack of protective effect of tears.
- Eyelid conditions where there is no complete closure of the eye like Bell’s palsy; ectropion can also lead to ulcers.
- Chemical injuries due to acidic or alkalic materials can also cause ulcer
- People who wear contact lenses are at an increased risk (10 fold with extended wear soft lenses) of corneal ulcers, especially when you forget to remove the lenses before going to bed and sleep with them. Scratches on the edge of your contact lens can scrape the cornea’s surface and make it more open to bacterial infections.
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Corneal Ulcer Symptoms
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- Red eye with severe pain
- Foreign body sensation in the eye
- Watering with pus or discharge from the eye
- Blurry vision
- Pain when looking at bright lights
- Swollen eyelids
- A white round spot on the cornea that is visible with the naked eye if the ulcer is very large
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Examination and Tests
You should see your ophthalmologist (eye specialist) immediately if any of the above symptoms are experienced, especially when you are wearing contact lenses. Eye specialist examines under a microscope (slit lamp) and uses special dye called Fluorescein to identify the ulcer. In some cases special laboratory tests are also required.
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Treatment
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If the ulcer is due to contact lens, remove contact lenses immediately. Apply cool compresses to the affected eye. Do not touch or rub your eye with your fingers. Limit spread of infection by washing your hands often and drying them with a clean towel. Take over-the-counter pain medications, such as paracetamol for pain.
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Medications
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- Requires antibiotic drops and sometimes may be needed every two hours along with other drops.
- In severe cases, even hospitalisation is also needed.
- Rarely, when there is a risk of perforation, surgical intervention is also needed.
- Coneal ulcer is an emergency and needs to be attended immediately. It can cause blindness and in very rare cases, if it spreads to the rest of your eyeball, even it can cause loss of eyeball.
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