Corneal Ulcer: Symptoms, Causes and Treatment

A corneal ulcer is a serious eye condition. When a patient is diagnosed, the treating ophthalmologist moves quickly to start a treatment plan — which may, in some cases, end with a corneal transplant to save the eye. If you have a corneal ulcer or know someone with the symptoms we are about to describe, please read on. This article covers what a corneal ulcer is, its causes, its symptoms, the treatment options, and how to protect your eyes from it.

What Is a Corneal Ulcer?

A corneal ulcer (also referred to as infectious keratitis) is an open sore on the surface of the cornea, caused by infection or trauma. It is an acute and serious condition; any delay in treatment can lead to permanent vision and ocular damage.

To put this in context: the cornea is the transparent layer that covers the front of the eye and through which we see. Any erosion, infection or scarring of this layer can That means cause major visual problems, especially if not treated in the early stages.

Causes of Corneal Ulcers

Corneal ulcers are most often caused by infections, including:

• Bacterial infections — frequently seen in contact lens wearers, particularly those who wear lenses for prolonged periods.
• Viral infections — for example the herpes simplex virus (which also causes cold sores), often triggered by stress, immune suppression, or sun exposure. The varicella-zoster virus (chickenpox / shingles) can also cause corneal ulcers.
• Fungal infections — improper use of contact lenses or steroid eye drops can lead to fungal infections, which in turn can cause corneal ulcers. Plant material entering the eye can also cause fungal keratitis and corneal ulceration.
• Parasitic infections (Acanthamoeba) — Acanthamoeba is a microscopic single-celled amoeba that can cause infection in humans. It is the most common amoeba in fresh water and soil. When Acanthamoeba enters the eye it can cause a serious infection, particularly in contact lens users. As you can see, improper contact lens hygiene is a recurring theme behind serious eye problems. There are also non-infectious causes, including:
• Severe dry eye is a common cause of corneal ulceration: if the eyelid does not function properly, the cornea can become dry and ulcerate.
• Vitamin A deficiency.
• Corneal scarring or burns from eye injury — even small abrasions and lacerations can become infected and lead to a corneal ulcer. These can result from fingernail scratches, paper cuts, makeup brushes, and similar everyday injuries.
• Poor circulation around the eye, which can be associated with conditions such as diabetes.

Symptoms of a Corneal Ulcer

The most common symptoms include:

• Redness of the eye.
• Severe eye pain and a foreign-body sensation.
• Pus or unusual discharge from the eye.
• Blurred vision and severe light sensitivity.
• Eyelid swelling.
• A sense of white spots or scarring on the eye that may not be visible to the naked eye.
• Itching or burning in the eye.
• General eye discomfort.

Treatment Options for Corneal Ulcers

1- Medication: the treating ophthalmologist will prescribe medication based on the underlying cause — typically eye drops, antibiotics, antivirals, or antifungals as appropriate. Pain relief may be added alongside the antibiotic regimen.

2- Surgery: if medication does not control the ulcer, or if the ulcer is severe, a corneal transplant may be needed. Your surgeon removes the affected cornea and replaces it with a healthy donor cornea. It is essential to choose a specialist surgeon and confirm the type of transplant required.

Top Doctors in Egypt for Treating Corneal Disease

Dr. Ahmed Shaarawy is a lecturer and consultant in cornea and refractive surgery at the Research Institute of Ophthalmology. He holds a PhD and a fellowship in corneal surgery from the Devers Eye Institute in Oregon, USA, where he trained under leading American eye surgeons. He was the first surgeon in Egypt to perform endothelial keratoplasty (DSAEK) using the S-stamp technique. He has taught this technique to many ophthalmologists and presented it at numerous conferences in the United States and the Arab world. Dr. Shaarawy is regarded as one of Egypt's most prominent eye surgeons, with a long record of successful operations and consistent use of the latest techniques in eye surgery. He has also published a new approach for lamellar corneal transplantation in cases that were historically difficult to treat with this technique.

Who Is at Higher Risk of Corneal Ulcers?

People at higher risk include:

– Contact lens wearers.

– Those who have had cold sores, chickenpox, or other infections noted above.

– Patients using steroid eye drops.

– Patients with severe dry eye.

– Patients with eyelid disorders that prevent normal lid function.

How to Protect Your Eyes from Corneal Ulcers

• Don't skip protective eyewear during activities that warrant it.
• Follow all of your doctor's instructions on contact lens wear and care.
• Avoid wearing contact lenses for prolonged periods.
• Don't sleep in your contact lenses.
• See your ophthalmologist promptly if you notice any eye problem of any kind, or if your eye is injured.

Finally, your eyes are among the most precious things you have — never hesitate to consult your ophthalmologist if you notice anything unusual.