Corneal Ulcer

What is a corneal ulcer?

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

What is the cause?

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 such as rheumatoid arthritis (when the body makes antibodies against part of itself)
• conditions that cause the cornea to lose feeling (such as infections or cornea surgery)

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 very serious. It can cause blindness or even loss of the eye if not treated. If you think you have a corneal ulcer, get help right away. Treatment depends on the cause of the ulcer. You may be given antibiotic eyedrops or ointment. You may also need eyedrops for pain, or steroid eyedrops to lessen scarring.

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.

You need to see your eye care provider often to make sure that the medicines you are using are effective. Severe corneal ulcers can cause a permanent scar even after treatment. If this scar affects your vision, you may need 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, contact your healthcare provider right away.
• If you are given drops to use, follow your healthcare provider's instructions carefully. 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.