A corneal ulcer is one of the more serious conditions an eye can face. Once it's diagnosed, treatment starts fast — and in severe cases it can end in surgery, such as a corneal transplant, to save the eye. If you have this condition, or you recognise the symptoms below in someone you know, keep reading. This guide covers what a corneal ulcer is, why it happens, what the warning signs look like, how it's treated, and how to protect yourself.
First, What Is a Corneal Ulcer?
A corneal ulcer — sometimes called keratitis — is an open sore or erosion on the surface of the cornea, usually set off by an injury or an infection. It is acute, and it is urgent. Delay treatment and the damage to your vision and your eye can be permanent.
A quick reminder: the cornea is the clear front window of the eye, the layer you actually see through. Any erosion, inflammation, or scarring here can cause real vision problems, especially when treatment comes late.
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In the spirit of sharing positive energy with patients considering corneal transplantation, here is a real story from someone who walked the same path you're considering today. We share it so you know there is a solution — and that the procedure is no longer as difficult as it once was, thanks to the advanced techniques Dr. Ahmed Shaarawy uses.
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Causes of Corneal Ulcer
Most corneal ulcers begin with an infection:
- Bacterial infection: the classic culprit in contact lens wearers, especially anyone who leaves lenses in for long stretches.
- Viral infection: the same virus behind cold sores (herpes simplex) can attack the cornea after stress, a weakened immune system, or sun exposure. The virus that causes chickenpox and shingles (varicella-zoster) can cause corneal ulcers too.
- Fungal infection: improper contact lens use or steroid eye drops can open the door to fungus, which can then lead to a corneal ulcer. Plant matter getting into the eye can also trigger fungal keratitis.
- Parasitic infection (Acanthamoeba): a microscopic single-celled amoeba found in fresh water and soil. Once it gets into the eye it can cause a severe infection — again, most often in contact lens users.
You'll notice a pattern here. Poor contact lens hygiene is one of the biggest risk factors for serious corneal infection — in our Cairo clinic, many of the ulcers we treat trace back to lenses worn too long or slept in. But infection isn't the only cause:
- Dry eye disease: if the eyelids don't blink and lubricate the surface properly, the cornea dries out and an ulcer can develop.
- Vitamin A deficiency.
- Scars or burns from a corneal injury: scratches and cuts can get infected and break down into an ulcer. Everyday objects do most of the damage here — fingernails, paper edges, makeup brushes.
- Poor blood flow to the eye area, which can come with systemic conditions such as diabetes.
Symptoms of Corneal Ulcer
So what does it actually feel like? These are the most common symptoms:
- Eye redness.
- Severe eye pain and the feeling that something is stuck in the eye.
- Pus or unusual discharge.
- Blurred vision and severe light sensitivity.
- Eyelid swelling.
- A sense of white spots or scarring in the eye that you may not be able to see in a mirror.
- Itching or burning.
- General eye discomfort.
Treatment Options for Corneal Ulcer
1. Medication: your doctor will prescribe treatment based on the underlying cause — typically eye drops, antibiotics, antivirals, or antifungals depending on the case. Pain relievers are often added to keep you comfortable while the ulcer heals.
2. Surgery: if medication isn't enough, or the ulcer is severe, you may need a corneal transplant. The damaged cornea is removed and replaced with healthy donor tissue. This calls for a specialist surgeon — and the right type of corneal transplant for your particular case.
Best Cornea Specialists in Egypt
Dr. Ahmed Shaarawy is a lecturer and consultant in cornea and refractive surgery at the Research Institute of Ophthalmology, with a PhD and a fellowship in cornea surgery from the Devers Eye Institute in Oregon, USA, where he trained under leading American cornea surgeons. He was the first surgeon in Egypt to perform S-stamp DMEK (endothelial keratoplasty) and has helped train many physicians in the technique through international and regional conferences. Dr. Shaarawy is recognised as one of Egypt's leading ophthalmologists, known for his outcomes and for working with the latest cornea surgery techniques. He has also published a novel approach to lamellar keratoplasty for cases where the standard technique was previously impractical.
Who Is at Higher Risk of Corneal Ulcer?
Your risk is higher if any of the following apply to you:
– You wear contact lenses.
– You have a history of cold sores, chickenpox, or the other infections mentioned above.
– You use steroid eye drops.
– You live with dry eye disease.
– You have an eyelid disorder that keeps the lids from closing properly.
How to Protect Your Eyes From Corneal Ulcer
- Wear proper eye protection for any activity that calls for it.
- Follow your doctor's instructions on contact lens wear and care to the letter.
- Avoid wearing contact lenses for long stretches.
- Never sleep in your contact lenses.
- See a doctor straight away if you notice any change in your eye, or after any eye injury.
Your eyes are your most precious asset. If something feels off, don't wait it out — see a specialist.