A corneal ulcer is a serious infection in the cornea – the clear, outer cover in the front part of the eye. There are different types of corneal ulcers including bacterial, viral, fungal and amoebic. Certain types of bacterial infections are very aggressive and can cause severe damage to the cornea, including permanent vision loss, if left untreated. With a corneal ulcer, the epithelium (the outermost layer of the cornea) becomes eroded, and the cornea loses its transparency and develops a gray-white opacity that can obscure vision. Patients with corneal ulcers usually experience pain, decreased vision, increased tearing, a sensation that something is in the eye, and light sensitivity.
Once the ulcer is diagnosed, an ophthalmologist or optometrist will begin treatment with appropriate topical medicine and may collect a lab specimen to identify the specific microorganism causing the ulcer. Managing a corneal ulcer requires experience and repetition, so request a referral to another doctor if your eye doctors doesn’t routinely treat corneal ulcers. Most ulcers respond to treatment but may result in a scar on the cornea and decreased vision. In more extreme cases, particularly for ulcers caused by the herpes simplex virus, repeated ulcers may cause so much corneal thinning that a corneal transplant is required.
Contact lens wearers are at an increased risk of developing corneal ulcers, especially those patients who sleep in their contacts. Contact lenses collect bacteria and reduce oxygen flow to the cornea, so overnight wearing habits increase the likelihood of infection. Other risk factors for the development of corneal ulcers include severe dry eye, traumatic abrasions of the cornea, and using tap water to clean contact lenses. If you suspect you have a corneal ulcer, contact your ophthalmologist or optometrist immediately.