Corneal ulcers

The cornea is the clear tissue at the front of the eye. A corneal ulcer is an open sore in the outer layer of the cornea. It is often caused by infection.

Most corneal ulcers are caused by infections:

• Bacterial infections cause corneal ulcers and are common in people who wearcontact 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 zoster virus (the virus that causes chickenpox and shingles).
• Fungal infections can cause corneal ulcers and may happen if you overuse eye drops that contain steroids.

Corneal ulcers or infections may also be caused by:

• Eyelids that do not close all the way, such as with Bell’s palsy
• Foreign bodies in the eye
• Scratches (abrasions) on the eye surface
• Severely dry eyes
• Severe allergic eye disease
• Various inflammatory disorders

Symptoms of infection or ulcers of the cornea include:

• Blurry or hazy vision
• Eye that appears red or bloodshot
• Itching and discharge
• Sensitivity to light (photophobia)
• Very painful and watery eyes
• White patch on the cornea

Treatment

Antibiotics, antifungal or antiviral eyedrops are the mainstay of treatment. Sometimes antifungal tablets will be prescribed, or an injection of medication is given near the eye for treatment. Once any infection has diminished or is gone, then steroid or anti-inflammatory eyedrops may be used to reduce swelling and help prevent scarring. The use of steroid eyedrops is controversial and should only be used under close supervision by your ophthalmology. It is possible that steroid eyedrops may worsen an infection. Oral pain medication may be prescribed to reduce pain. If corneal ulcers cannot be treated with medication, surgery may be needed to keep your vision. A corneal transplant can replace your damaged cornea with a healthy donor cornea to restore vision.