Corneal Ulcer - Symptom, Causes, Treatment of Corneal Ulcer

Corneal Ulcer is the ulceration of the surface membrane that covers the cornea (transparent area in front of the coloured part of the eye). Corneal ulcers are painful, and patients often feel that there is something in their eye. Corneal Ulcers are local necrosis of corneal tissue due to invasion by bacteria, fungi, viruses, or amebas found in soil, sewage and water. Corneal ulcers will fail to heal for two general reasons.  The first set of reasons would be due to external causes.  These causes would include entropion - an abnormal rolling in of the eyelid, or trichiasis - facial hair which is in contact with the eye as a result of facial conformation.  Also, foreign bodies lurking behind the third eyelid, embedded within the eyelid or in the cornea itself, and abnormally placed eyelashes - called ectopic cilia - are causes of ongoing corneal trauma.

Causes of Corneal Ulcer

Corneal ulcers may be caused by chemical mechanical or irradiation injuries to the cornea; the Jatter include damage due to ultraviolet rays from flash-burns in weldin, or snow blindness. There are many causes of corneal ulcers.  Contact lens wearers (especially soft) have an increased risk of ulcers if they do not adhere to strict regimens for the cleaning, handling, and disinfection of their lenses and cases.  Soft contact lenses are designed to have very high water content and can easily absorb bacteria and infecting organisms if not cared for properly.  Pseudomonas is a common cause of corneal ulcer seen in those who wear contacts. 

Symptom of Corneal Ulcer

Corneal ulceration causes severe pain in the eye; watering; spasm of the lids that prevents proper opening of the eye; and often a ring of redness and congested blood vessels radiating out from the edge of the cornea. The cornea is intensely sensitive, so corneal ulcers normally produce severe pain . If the corneal ulcer is centrally located, vision is impaired or completely absent. Tearing is present and the eye is red. It hurts to look at bright lights. The symptoms associated with corneal ulcers depend on whether they are infectious or sterile, as well as the aggressiveness of the infecting organism.

• Red eye 
• Severe pain (not in all cases)
• Tearing
• Discharge 
• White spot on the cornea, that depending on the severity of the ulcer, may not be visible with the naked eye
• Light sensitivity

Diagnosis of Corneal Ulcer

If suspected from the history and symptoms, a corneal ulcer can be confirmed by examination of the eye with a magnifying glass after instilling a drop of dye that temporarily stains the ulcerated area. Corneal ulcers are diagnosed with a careful examination using a slit lamp microscope. Special types of eye drops containing dye such as fluorescein may be instilled to highlight the ulcer, making it easier to detect. An instrument called a slit lamp will be used to examine the cornea. The slit lamp is a microscope with a light source that magnifies the cornea, allowing the extent of the ulcer to be seen.

Treatment of Corneal Ulcer

If caustic chemicals splash into the eye in Corneal Ulcer disease, immediately flush it with plenty of water. If ulceration is confirmed, drops or ointments are used to dilate the pupil (which helps to relieve the pain) and to prevent infection, and the eye is kept closed and covered with a pad until it has healed completely (usually within a couple of days). 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. For corneal ulceration that is caused by viral infection, antiviral ointment and tablets may be advised.

Prevention of Corneal Ulcer

Protective goggles should be worn, when there is any risk of eye injury from dust or other particles, or from machinery, chemicals or ultraviolet rays.

• Do not wear your lenses for prolonged periods of time.
• Wash your hands before handling contacts.
• Do not wear your contacts overnight.

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