The cornea is the front layer of eye tissue, which is clear and allows the light to enter the eye. The cornea is protected from bacterial infections, viruses and other problems by the tears.
A corneal ulcer is an open sore, which develops on the clear surface of the cornea, typically because of an infection. Moreover, wearing contact lenses for a prolonged period and small injuries to the eye can cause the cornea to form an ulcer.
Reason for corneal ulcer
The primary cause of corneal ulcer is an infection. Some of the most common eye infections that can lead to the formation of a corneal ulcer are:
Acanthamoeba Keratitis: This type of infection mostly occurs in people who wear contact lenses.This is a type of amoebic infection and in some rare cases; the worsening of this infection can also cause blindness.
Herpes Simplex Keratitis: This a form of viral infection which leads to viral lesion flare-ups or causes sores in the eyes. This can be due to stress, excessive exposure to the sunlight, or a problem that impacts the body’s immune system.
Fungal Keratitis: This kind of infection develops post an injury to the cornea of the eye. This injury is typically caused because of a plant or a related material. This condition is most common in people who have a weak immune system.
Apart from these infections, there are several other reasons, which can cause to formation of a corneal ulcer. These include:
- Dry eyes
- Inflammatory problems
- Injury to the eye
- Deficiency of Vitamin A
- Unsterilised contact lenses
Moreover, people who wear disposable contact lenses for a long period, including overnight, are at a higher risk of corneal ulcer. Moreover, expired soft lenses can also lead to the formation of ulcers.
Symptoms of corneal ulcer
The corneal ulcer first produces signs of infection, which can further be related to a corneal ulcer. Some symptoms of a corneal ulcer include:
- Itchy eyes
- Watery eyes
- Pus-like discharge from the eyes
- Extreme sensitivity to light
- Red or pink eye
- Burning or a stinging sensation in the eyes
That said, symptoms of the corneal ulcer itself include:
- Inflammation in the eyes
- Sore eyes
- Consistent tearing
- Blurred vision
- White spots on the cornea
- Swelling in the eyelids
- Pus or discharge from the eyes
- Sensitivity to light
- The feeling of a unfamiliar particle in the eye
No matter the intensity of symptoms, all signs of corneal ulcers should be treated immediately to avoid the risk of blindness.
Diagnosis of corneal ulcer
A corneal ulcer is diagnosed by an eye doctor through an eye exam. A particular test to examine the ulcer is called fluorescein eye stain. In this test, the doctor puts an orange dye on top of the blotting paper. This dye is then transferred to the eye by touching the blotting paper to the eye surface only slightly.
Once done, the doctor uses a microscope known as slit-lamp to direct violet light into the eye. This helps the doctor assess any damaged areas of the cornea. The damaged or affected areas will appear green upon being directed with violet light. If an ulcer is found on the cornea, the doctor will further investigate the cause of the problem. This will be done by scraping a thin layer of the ulcer by placing the numbing eye drops in the patient’s eyes. This will help the doctor know if the ulcer is caused due to bacteria, fungi or a virus.
Treatment of corneal ulcer
After the exact cause of corneal ulcer is diagnosed, the doctor will recommend antibacterial, antifungal or antiviral eye medications to treat the issue. In case of severe infections, the patient may be advised to take antibacterial eye drops until the cause of the infection is determined. Moreover, the doctor may recommend corticosteroid eye drops to check for the inflammation and swelling.
During treatment, the doctor will advise the patient to avoid:
- Wearing contact lenses
- Applying makeup
- Taking other medications
- Avoid touching the eyes regularly
In some severe cases, the doctor can also suggest a corneal transplant. A corneal transplant involves removing the corneal tissue through surgery and replacing it with donor tissue. This is a fairly safe procedure to correct the corneal ulcer. However, it still has some risks and complications, such as:
- Rejection of the donor cornea tissue
- Glaucoma (excessive pressure in the eye)
- Eye infection
- Clouding of eye’s lens, called cataract
- Swelling in the cornea
Preventing a corneal ulcer
Foremost, it is important to treat the ulcer as soon as a symptom appears. This helps to minimise future risks and complications. Moreover, in case of an eye infection or eye injury, the person should get checked for a corneal ulcer too.
Some other tips that can help prevent corneal ulcers include:
- Avoid sleeping with contact lenses
- Wearing contact lenses after sterilising them or cleaning them
- Rinsing the eyes to remove any foreign object
- Washing handing before touching the eyes
That said, overall a corneal ulcer can easily be treated but can cause a reduction in the eye ulcer. However, for patients that are not treated with the right care, the corneal ulcer can cause a loss of vision, visual obstruction because of scarring of the retina. In rare cases, the problem intensifies to damage the entire eye.