Corneal Ulcer

How does a corneal ulcer develop?
What steps can you take to lower your risk of developing a corneal ulcer?

The front portion of the eye is covered with a thin, transparent membrane called the cornea, which protects the interior of the eye (See Anatomy of the Eye). A corneal ulcer results from a break or defect in the surface layer of the cornea, called the epithelium, with subsequent damage to the underlying stroma. The ulcer is usually caused by microrganisms, which gain access to the stroma through the break in the epithelium. There are many types of corneal ulcers, characterized according to location, depth, associated diseases, and cause.

How does a corneal ulcer develop?

Corneal ulcers can begin with a wound to the surface of the eye, or they may result from eyelashes that irritate the surface, ill-fitting contact lenses, prolonged use of contact lenses, eyelid and conjunctiva infections, lack of tear production, and defective closure of the eyelid. Those most at risk for developing corneal ulcers have had a recent infection or eye injury, are around smoke or other environmental irritants, or wear contact lenses.

Corneal ulcers are painful, and patients often feel that there is something in their eye. Other symptoms include redness in the white of the eye, excessive tearing, sensitivity to bright light, squinting, eyelid spasms, and a discharge from the eye.

What steps can you take to lower your risk of developing a corneal ulcer?

There is no guaranteed way to prevent infection when there is an injury to the corneal epithelium, so see an eye doctor even for relatively minor injuries. Diagnostic tests may include a general eye examination, a visual acuity test, and a culture study of the corneal scraping. If a foreign body is in the eye, it is removed, medication is administered, and the eye is patched. Treatment depends on the type and depth of the ulcer and usually consists of topical antibiotic drops. Severe corneal ulcers may require surgery.

If you wear contact lenses, you can take steps to lessen the risk of developing a corneal ulcer.

Do not wear your lenses for prolonged periods of time.
Wash your hands before handling contacts.
Do not wear your contacts overnight. Doing so deprives the cornea of oxygen and makes it less resistant to infection. Also, microbes can adhere to soft contact lenses, and overnight wear gives those microbes more time to invade the cornea and cause an infection. Fortunately, only a small percentage of contact lens wearers develop corneal ulcers.

If you have a corneal abrasion of any kind, have it treated promptly, and watch for signs of infection, which could indicate a corneal ulcer.

Corneal ulcers are a serious vision-threatening condition and require prompt medical attention. If left unattended, corneal ulcers may penetrate the cornea, allowing infection to enter the eyeball, which can cause permanent loss of vision and possible loss of the eye. If treated early and properly, corneal ulcers are usually curable in 2 to 3 weeks. If a corneal ulcer is suspected, see an eye doctor immediately.