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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.
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.
Most corneal ulcers begin with an infection:
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:
So what does it actually feel like? These are the most common symptoms:
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.
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.
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.
Your eyes are your most precious asset. If something feels off, don't wait it out — see a specialist.
