A corneal ulcer is an open sore on the cornea, usually due to infection following an epithelial defect. It is a vision‑threatening emergency requiring prompt assessment and treatment.
Causes and Symptoms
Bacterial, fungal, viral, or amoebic infections can all cause ulcers, particularly in contact lens wearers or eyes with trauma or severe dry eye.
- Symptoms include severe pain, redness, discharge, light sensitivity, and reduced vision.
- Examination reveals a focal epithelial defect with underlying stromal infiltrate and often surrounding oedema.
- Intraocular inflammation and hypopyon may be present in more advanced cases.
- Untreated ulcers can perforate and lead to endophthalmitis or scarring.
Treatment
Management involves intensive topical antimicrobial therapy tailored to the suspected organism and culture results.
- Frequent follow‑up is needed to monitor healing and adjust treatment.
- Cycloplegic drops relieve pain and help prevent synechiae.
- Adjunctive measures such as lubricants, bandage contact lenses, or amniotic membrane grafts support epithelial healing.
- Residual scarring may require optical correction or keratoplasty.
