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Definition:

The cornea is the transparent area at the front of the eyeball. A corneal ulcer is an erosion or open sore in the outer layer of the cornea. It is associated with infection.

See also: Corneal injury



Alternative Names:

Bacterial keratitis; Fungal keratitis; Acanthamoeba keratitis; Herpes simplex keratitis



Causes, incidence, and risk factors:

Corneal ulcers are most commonly caused by an infection with bacteria, viruses, fungi or parasite. Other causes include:

  • Abrasions (scratches)
  • Foreign bodies in the eye
  • Inadequate eyelid closure
  • Severely dry eyes
  • Svere allergic eye disease
  • Various inflammatory disorders

Contact lens wear, especially soft contact lenses worn overnight, may cause a corneal ulcer. Herpes simplex keratitis is a serious viral infection. It may cause repeated attacks that are triggered by stress, exposure to sunlight, or any condition that impairs the immune system.

Fungal keratitis can occur after a corneal injury involving plant material, or in immunosuppressed people. Acanthamoeba keratitis occurs in contact lens users, especially those who attempt to make their own homemade cleaning solutions.

Risk factors are dry eyes, severe allergies , history of inflammatory disorders, contact lens wear, immunosuppression, trauma, and generalized infection.



Signs and tests:

Blood tests to check for inflammatory disorders may also be needed.



Treatment:

Treating corneal ulcers and infections depends on the cause. They should be treated as soon as possible to prevent further injury to the cornea. Patients usually start treatment with antibiotic that is effective against many bacteria. More specific antibiotic, antiviral, or antifungal eye drops are prescribed as soon as the cause of the ulcer has been identified.

Corticosteroid eye drops may be used to reduce inflammation in certain conditions. Severe ulcers may need to be treated with corneal transplantation.



Support Groups:



Expectations (prognosis):

Untreated, a corneal ulcer or infection can permanently damage the cornea. Untreated corneal ulcers may also perforate the eye (cause holes), resulting in spread of the infection inside, increasing the risk of permanent visual problems.



Complications:
  • Loss of the eye
  • Severe vision loss
  • Scars on the cornear


Calling your health care provider:

Call your health care provider if you develop impaired vision, severe light sensitivity, or eye pain.



Prevention:

Prompt, early attention by an ophthalmologist for an eye infection may prevent ulcers from forming. Wash hands and pay very close attention to cleanliness while handling contact lenses. Avoid wearing contact lenses overnight.



References:

Butler FK. The Eye in the Wilderness. In: Auerbach PS, ed. Wilderness Medicine. 5th ed. St. Louis, Mo: Mosby; 2007:chap 25.




Review Date: 8/27/2008
Reviewed By: Manju Subramanian, MD, Assistant Professor in Ophthalmology, Vitreoretinal Disease and Surgery, Boston University Eye Associates, Boston, MA. Review provided by VeriMed Healthcare Network.

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
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789 Central Avenue, Dover, NH 03820
Phone: (603) 742-5252
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