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  Corneal Ulcer

Corneal Ulcer is an ulcer on the cornea, the clear membrane that covers the iris and pupil. The iris is the colored portion of the eye surrounding the pupil. An ulcer is an open sore that sometimes is difficult to heal.

Corneal Ulcer Eye diseases
Corneal Ulcer


Cause

Corneal ulcers are most commonly caused by infections. Bacterial infections are usually seen in patients who wear contact lenses. Viral infections are a possible cause of corneal ulcers. The viruses that have caused corneal ulcers are herpes simplex, which causes cold sores and varicella virus which causes shingles and chicken pox. Fungal infections have also been a cause of corneal ulcers especially if over use of steroid eye drops occurs.

Immune disorders of the eyes have left the eyes unable to fight germs because of decrease in tears. Small rips in the cornea can lead to corneal ulcers. These rips are the result of traumatic injury, scratches, and particles such as glass, sand, steel and dirt. The damage to the cornea enables bacteria to invade.

Eyelid disorders that affect the eye from closing properly can cause dryness leading to ulcers. Bell’s palsy is one such condition. Chemical burns from splashed caustic solutions can also injure the cornea. Contact lens users are ten times more likely to develop corneal ulcers. Extended wear contact lens wearers are particularly susceptible.

Symptoms

A corneal ulcer usually only occurs in one eye. The symptoms are red eye, severe pain, the feeling that there is something in the eye, tearing, watery eyes, pus or thick discharge, blurry vision, swelling of the eyelids, pain in bright lights,. Sometimes a white round spot is visible on the cornea if the ulcer is large.

Diagnosis

Corneal ulcers are serious and diagnosis is important. Diagnosis is made by an ophthalmologist, a doctor who is trained in eye care and eye surgery. A slit lamp is a special microscope that is used to examine the eyes. An ophthalmologist uses special eye drops with the dye flourescein that can help detect injuries to the eye, when viewed with a slit lamp. Sometimes an ophthalmologist will take samples of the ulcer for lab work to determine the source of the ulcer, if an infection is suspected.

Treatment

The ophthalmologist will remove contact lenses if the patient has them. Usually an eye patch is not required; especially if a bacterial infection is suspected. Eye patches will enable further growth of the bacteria. If the ulcer is severe hospitalization may be required. If the infection appears to be of a common source, then antibiotic eye drops will be prescribed. If the infection is severe, oral antibiotics or hourly eye drops may be prescribed. Oral pain medication can be prescribed for pain control. Pain can also be alleviated with eye drops that keep the pupil dilated.

Rarely an ulcer is so severe that a corneal transplant is required. If the ulcer cannot heal or is too large to be treated or threatens to perforate the eye, then a corneal transplant is performed.

If the corneal ulcer is treatable, daily phone call follow-ups with an ophthalmologist is recommended. If the pain worsens or the symptoms do no clear or a fever develops, the ophthalmologist should be contacted immediately.

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