Corneal ulcers: symptoms, causes, and treatment

What is a corneal ulcer

Corneal ulcers are open sores that occur on the cornea. This eye disease usually occurs due to infection. Even a minor eye injury or erosion from wearing contact lenses for too long can lead to infection.

The cornea is the thin layer on the front of the eye. The cornea works like a window that allows light to enter the eye. Tears protect the cornea from bacteria, viruses, and fungi.

How common is this condition?

This condition is very common and can affect patients of any age. Corneal ulcers can be treated by reducing risk factors. Talk to your doctor for more information.

Symptoms of a corneal ulcer

Corneal ulcers are caused by infection. This infection will cause symptoms, such as:

• Itchy eyes
• Red eye
• Severe pain
• Feel like there is something in the eye
• Watery eyes
• Pus or thick discharge from the eye
• A burning or stinging sensation in the eye
• Sensitive to light

Meanwhile, the symptoms of a corneal ulcer itself are:

• Inflammation of the eye
• Sore eyes
• Excessive tears
• Blurred vision
• There are white or gray spots on the cornea
• Swollen eyelids
• The pus comes out of the eye
• Sensitive to light
• The feeling like something is in your eye.

Some corneal ulcers are too small to see with the naked eye. However, you can usually feel the symptoms.

There may be signs and symptoms not listed above. If you have concerns about a particular symptom, consult your doctor.

When should I see a doctor?

You should contact your doctor if you experience any of the following symptoms:

• Changes in vision
• Severe pain
• The feeling like something is in the eye
• Fluid out of the eye
• History of scratching to the eye or exposure to flying chemicals or particles

Causes of corneal ulcers

According to the American Academy of Ophthalmology, the main cause of corneal ulcers is usually an infection. Here are some types of infections that may cause injury to your cornea:

1. Bacterial infection

Bacterial infections cause corneal ulcers and are common in people who wear contact lenses.

2. Viral infection

Viral infection is also a possible cause of this disease. Viruses such as herpes simplex can cause you to have recurrences. A recurrence of the disease can be triggered by stress, an immune system disorder, or sun exposure.

The varicella virus (the virus that causes chickenpox) can also cause corneal ulcers.

3. Fungal infection

Yeast infection is a less common cause of corneal ulcers. Yeast infection can occur after you get an eye injury from organic material, such as branches or twigs.

People affected by this type of infection have used steroid eye drops or non-sterile contact lenses.

4. Parasitic infection (Acanthamoeba)

Acanthamoeba is a single cell microscopic amoeba that can cause infection in humans. These amoebae are most common in fresh water and soil.

When Acanthamoeba gets into the eye, it can cause a bad infection, especially for contact lens wearers.

Other causes of corneal ulcers include:

• Dry eyes. Disorders that cause dry eyes can cause the eyes to lack protection against germs and cause ulcers.
• Eye injury. A slight tear on the cornea can also cause injury.
• Inflammatory disorders.
• Using non-sterile contact lenses.
• Vitamin A deficiency.

People who wear expired contact lenses or disposable contact lenses for a long period of time (including overnight wear) are also at increased risk for this condition.

Risk factors

There are several factors that can increase your risk of developing corneal ulcers, such as:

• Herpes
• Chicken pox
• Using contact lenses
• Trauma to the cornea

Diagnosis & treatment

The information provided is not a substitute for medical advice. ALWAYS consult your doctor.

How is this condition diagnosed?

Eye infection can be a serious problem. That is why, you should immediately see an eye doctor. Before determining a diagnosis, usually the doctor will perform tests, such as:

• Examination slit-lamp (slit lamp). The eye doctor can detect if you have an ulcer using a special eye microscope, or slit-lamp . To make it easier to see, the doctor will drip a drug containing a dye fluorescence on the eye.
• Lab examination . If your condition is suspected to be due to an infection, your doctor may take a sample of the ulcer to send to the laboratory.

How are corneal ulcers treated?

Once your eye doctor determines the cause of the corneal ulcer, the doctor may treat the corneal ulcer with the following treatment options:

1. Medicines

Your doctor can give you antibacterial, antifungal, or antiviral eye medication depending on what is the cause.

If the infection is caused by bacteria, your doctor may give you antibiotic eye drops. In rare cases, the doctor may inject the drug near the eye.

2. Eye drops

You may also be prescribed corticosteroid eye drops. Doctors usually give these eye drops if the eye is inflamed and swollen.

The eye drops will reduce swelling and help prevent scarring from corneal ulcers. This medication should be under the close supervision of a doctor as eye drops may worsen the infection.

3. Corneal transplant

In severe cases, corneal ulcers may require a corneal transplant. A corneal transplant can replace the damaged cornea with a donor cornea to restore vision.

Corneal transplant can be considered while the wound is still there even after treatment. This surgery can lead to health complications such as:

• Donor tissue rejection
• Trigger glaucoma (pressure in the eye)
• Eye infection
• Cataract (cloudy eye lens)
• Swelling of the cornea

Home remedies

What are some lifestyle changes or home remedies that can be done to treat corneal ulcers?

Here are lifestyle and home remedies that can help you deal with this condition:

• Do not use contact lenses while the infection is still there.
• Use a cold compress on the affected eye.
• Do not touch or rub your eyes with your fingers, especially if your hands are dirty.
• Limit the spread of infection by washing your hands frequently and drying them with a clean towel.
• Use over-the-counter pain relievers, such as acetaminophen (Typlenol) or ibuprofen.
• Avoid sleeping while still wearing contact lenses.
• Clean and sterilize contact lenses before and after use.
• Rinse eyes to remove foreign objects.
• Wash your hands before touching your eyes.

If you have any questions, consult your doctor for the best solution to your problem.