A corneal ulcer is an inflammation occurring on the thin, clear covering of the eye–the cornea.
The ulcer is actually an open sore which can be very painful and cause distortion in vision.
This is a condition which is considered extremely serious. If treated quickly, a full recovery is possible. However, if left untreated, a corneal ulcer can eventually lead to a partial or complete loss of sight. It is therefore vitally important that medical advice is sought as quickly as possible to prevent permanent damage.
What is a corneal ulcer?
Corneal ulcers are often brought about by an infection of the cornea. The cornea becomes inflamed when cells on the surface (known as epithelium) brake down.
An open sore is created which usually appears as a gray or white patch on the otherwise clear surface. These patches are so small they may be undetectable without magnification.
Many eye conditions present similar symptoms. You may think you have a simple eye infection before realizing you have a corneal ulcer. There are a number of things to look out for. These include:
- White or grey spots on the cornea.
- Feeling as though there is something in the eye, such as a piece of grit, for example.
- Swollen eyelids.
- A blurring of vision.
- Increased sensitivity to light.
- Pain or discomfort.
- A thick discharge coming from the eye.
If you notice any of these symptoms, speak to your doctor or an eye specialist as soon as possible.
The most common cause of a corneal ulcer is infection. Tiny particles of sand, dirt, or metal can scratch the cornea. These scratches are then invaded by bacteria, which ultimately leads to ulceration.
If you’re suffering from dry eyes, you are more susceptible to ulcers. Tears help to clean the eye and prevent germs from spreading. When the eye does not produce enough tears, bacteria is able to thrive.
Disorders such as Bell’s palsy, which prevents the eye or eyes from closing properly, can also cause the eye to dry out. Affecting the muscles, these conditions sometimes cause the eyelid to turn inwards. This can lead to the eyelid rubbing against the cornea, causing abrasions.
If you are suffering from a fungal infection, you may already be treating it with steroid eye drops. But the overuse of these can increase the chance of the eye becoming infected. To prevent this, use steroid eye drop exactly as prescribed and see your eye specialist of you have any concerns.
Viral infections, such as the herpes simplex virus (the cause of cold sores), can affect the eye and nose. If this happens, there is the possibility of an ulcer forming.
Corneal ulcers and contact lenses
Although they can affect both adults and children, corneal ulcers occur more often in contact lens wearers. And wearing extended-wear lenses–those that are kept in for several days or overnight–increases this chance even more.
Always follow the hygiene advice for cleaning contact lenses. If bacteria get on the underside of the lens, they will multiply and damage the cornea. Any dirt or slight defect on the lens can also scratch the cornea causing infection.
Will it heal itself?
The simple answer is no. A corneal ulcer is a very serious condition and will always require treatment. Medical attention should be sought as soon as symptoms present themselves.
There are some steps that can be taken at home before you are able to visit a doctor. Remove contact lenses. Keep your hands clean and avoid rubbing your eyes. Use a cool compress on the eye. These actions are only initial steps and your doctor will prescribe full treatment.
Diagnosis and treatment
As the ulcers are often too small to see with the naked eye, a doctor will carry out an eye exam. They may use a specialized microscope and a dye making the ulcer easier to see. A scraping may be taken to send for analysis to identify the cause of infection.
Treatment will be prescribed to combat the cause of the corneal ulcer. Because of this, medications will vary from patient to patient. As bacterial infections are the most common, antibiotic eye drops are often given. If the ulcer is very big, these drops may have to initially be used on an hourly basis.
Pain relief may also be given orally or through an eye drop.
Contact lenses should be removed immediately and not used again until a full recovery has been made. Avoid make-up and excessive touching of the eye.
In the most extreme cases, when treatment is unsuccessful, emergency surgery and a corneal transplant may be required.
How long does it take to heal?
The healing process is a long one. How long is dependent on the individual patient, the size and depth of the ulcer, and the cause of infection. After two or three weeks, improvement should be noticeable if the treatment plan is followed. However, more time will usually be required to prevent any permanent scarring from appearing.
How to prevent a corneal ulcer
Corneal ulcers are preventable and there are small steps that can be taken in your everyday life.
When exposed to small particles, wear protection such as goggles or glasses. Always use eye protection when handling power tools.
If you suffer from dry eyes or are unable to close your eyelids fully, lubricate your eyes with artificial tears.
Contact lens wearers should be extra careful to follow the hygienic cleaning instructions. Ensure your hands are clean before handling them. Don’t use tap water or your saliva to clean your contact lenses.
Be sure to clean the lens case on a regular basis. When your eyes are feeling irritated, give them a rest and remove your contact lenses. Avoid wearing your lenses when sleeping.
A corneal ulcer is a serious eye condition. At the first sign of symptoms, no matter how trivial they seem, do not delay. Make an appointment or walk in as soon as possible to see one of our specialists here at The New Jersey Eye Center in Bergenfield or Passaic, NJ.