Corneal Ulcer Overview
A corneal ulcer is an open sore on the cornea, the thin clear structure overlying the iris, which is the colored part of your eye.
Corneal Ulcer Causes
- Most corneal ulcers are caused by infections.
- Bacterial infections cause corneal ulcers and are common in people who wear contact lenses.
- Viral infections are also possible causes of corneal ulcers. Such viruses include the herpes simplex virus (the virus that causes cold sores) or the varicella virus (the virus that causes chickenpox and shingles).
- Fungal infections can cause corneal ulcers and may happen if you overuse eyedrops that contain steroids.
- Tiny tears to the cornea may also cause corneal ulcers. These tears can come from direct trauma; scratches; or particles, such as sand, glass, or small pieces of steel. Such injuries damage the cornea and make it easier for bacteria to invade and cause a serious ulcer.
- Disorders that cause dry eyes can leave your eye without the germ-fighting protection of tears and cause ulcers.
- Disorders that affect the eyelid and prevent your eye from closing completely, such as Bell's palsy, can dry your cornea and make it more vulnerable to ulcers.
- Chemical burns or other caustic (damaging) solution splashes can injure the cornea.
- People who wear contact lenses are at an increased risk of corneal ulcers. In fact, your risk of corneal ulcerations increases 10-fold when using extended-wear soft contact lenses. Extended-wear contact lenses are those contact lenses that are worn for several days without removing them at night. Contact lenses can damage your cornea in many ways.
- Scratches on the edge of your contact lens can scrape the cornea’s surface and make it more open to bacterial infections.
- Similarly, tiny particles of dirt trapped underneath the contact lens can scratch the cornea.
- Bacteria may be on the lens or in your cleaning solutions and, thus, get trapped on the undersurface of the lens. If your lenses are left in your eyes for long periods of time, these bacteria can multiply and cause damage to the cornea.
- Wearing lenses for extended periods of time can also block oxygen to the cornea, making it more susceptible to infections.
Corneal Ulcer Symptoms
- Red eye
- Severe pain
- Feeling that something is in your eye
- Pus or thick discharge draining from your 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
When to Seek Medical Care
- Change in vision
- Severe pain
- Feeling that there is something in your eye
- Obvious discharge draining from your eye
- History of scratches to the eye or exposure to chemicals or flying particles
Exams and Tests
Because corneal ulcers are a serious problem, you should see your ophthalmologist (a medical doctor who specializes in eye care and surgery).
- Your ophthalmologist will be able to detect if you have an ulcer by using a special eye microscope, known as a slit lamp. To make the ulcer easier to see, he or she will put a drop containing the dye fluorescein into your eye.
- If your ophthalmologist thinks that an infection is responsible for the ulcer, he or she may then get samples of the ulcer to send to the laboratory for identification.