Corneal ulcers are open sores that develop on the cornea, the transparent layer at the front of the eye. These ulcers may form if a person has an eye infection, very dry eyes, or sleeps with their contact lenses in.

Ophthalmologists consider corneal ulcers an emergency. Without treatment, they can lead to scarring or vision loss.

This article focuses on the symptoms that may appear with a corneal ulcer. It also discusses the causes, diagnosis, and treatment of corneal ulcers.

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Possible symptoms of a corneal ulcer include:

  • eye discharge
  • blurred vision
  • swollen eyelids
  • eye redness
  • a feeling that there is something in the eye

Infections are usually the main cause of corneal ulcers. In addition to bacterial infections, viral, fungal, and parasitic infections can also cause corneal ulcers. Some of these include:

  • Herpes simplex virus: The cold sore virus can cause corneal infection and may lead to pain, blurred vision, or vision loss. Sun exposure or immune system issues can cause flare-ups to occur.
  • Fungal keratitis: This fungal infection can develop due to corneal injury or steroid eye drop use.
  • Acanthamoeba keratitis: This parasitic infection develops when contact lenses come into contact with water carrying the amoeba, which enters the eye and destroys its tissue. According to a 2019 study, this can happen when someone does not remove their contacts before showering or cleans them with tap water.

Corneal ulcers are common in people who wear contact lenses, especially those who wear them for a long time and sleep with them in.

Contact lenses are safe as long as wearers follow good handling practices. The Centers for Disease Control and Prevention (CDC) suggest that people wash their hands before putting in contact lenses and store them in disinfecting solution.

Other possible causes of corneal ulcers include:

Additionally, a person may have a higher chance of getting a corneal ulcer if they:

  • have diabetes
  • have undergone ocular surgery in the past
  • use corticosteroids
  • use eye medications that are contaminated
  • engage in agricultural work

Diagnosing corneal ulcers occurs during an eye exam.

An ophthalmologist uses a fluorescein eye stain test to diagnose a corneal ulcer. It involves using fluorescein dye on the eye’s surface to light up the area and a slit lamp, which allows them to look closely at any corneal damage.

The eye doctor may also take a tissue sample if they believe the ulcer results from an infection.

Treatment for corneal ulcers involves treating the underlying issue and may require medication.

Medications

According to the American Optometric Association, antibiotic eye drops or ointment may help prevent an infection if a person has corneal abrasion. A person can also take over-the-counter pain medication to ease the pain.

Steroid drops may help reduce inflammation and scarring, but doctors do not start prescribing them until the top layer of the cornea has healed. However, these drops can also increase the risk of infection, recurrent ulcers, and perforation.

Some people may have to undergo corneal transplant surgery if they still have a scar after treating the infection and ulcer. During the procedure, the surgeon replaces the cornea with an undamaged one from a deceased donor to help improve vision.

Home care

People with a corneal ulcer should follow the treatment plan that a doctor has recommended.

However, they can also help protect their eyes and manage discomfort by:

  • avoiding wearing contact lenses
  • avoiding rubbing their eyes
  • washing their hands to limit the spread of infection
  • applying a cool compress

A corneal ulcer is treatable, but a person needs to consult their doctor if their symptoms worsen or they experience vision loss or severe eye pain.

It may be a suitable idea to follow some tips to help prevent vision loss and corneal ulcers from forming.

The National Eye Institute recommends people wear protective eyewear if they play sports or use chemicals. Protecting the eyes can help reduce the likelihood of corneal injury.

The CDC also recommends:

  • washing hands before inserting and removing contact lenses
  • disinfecting and replacing contact lenses regularly
  • quitting smoking if applicable, as smoking may increase the risk of vision issues
  • maintaining blood sugar levels — high blood pressure can lead to vision problems

The recovery time from a corneal ulcer depends on the cause. For example, if it results from a severe infection, it may take longer to heal.

People may have to attend follow-up visits while treating a corneal ulcer. During these visits, the doctor can check that the eye is responding well to treatment and there is no risk of complications.

Corneal ulcers are serious, and healthcare professionals should treat them as an emergency. Without treatment, a person may be at high risk of developing glaucoma, irregular astigmatism, and perforation. Vision loss is also possible.

Corneal ulcer and keratitis are two conditions that can cause vision loss.

Corneal ulcers are open wounds that, in most cases, develop from an infection.

Keratitis refers to diseases that cause corneal inflammation. It can occur from improper contact lens use and can also lead to ulcers.

Learn more about keratitis.

People who notice unusual eye symptoms need to speak with an eye doctor for further evaluation. They can also consult a doctor if they experience pain, redness, or sensitivity to light.

They should also seek medical care if they have a corneal ulcer and their symptoms do not improve with treatment.

Corneal ulcers are an emergency and require immediate medical attention. Without proper treatment, they can lead to scarring or vision loss.

They are more likely to develop in people who sleep in their contact lensesand do not clean their hands before handling them. They can also occur in individuals who wear their contacts longer than an eye specialist recommends.

Eye drops and medications can help reduce inflammation and pain. However, proper contact lens hygiene is also essential during treatment to prevent complications.