What is a corneal ulcer? Is it an eye emergency?

Corneal ulcer is a vision threatening eye emergency, and you must see an eye doctor immediately, for smaller peripheral corneal ulcers in a non-contact-lens wearer can be referred semi-urgently.

What is a corneal ulcer? Is it an eye emergency? in Santa Clarita

What is a corneal ulcer?

A corneal ulcer is a wound that appears on the surface of your cornea caused primarily by infection, but not necessarily. Your cornea is the front part of the eye. It helps keep the rest of the eye clean and free of germs. An ulcer can also form on your cornea if you have an injury to your cornea. Anyone can develop a corneal ulcer, regardless of age. The severity of corneal ulcers can vary depending on their cause. Use of contact lenses is the leading cause of corneal ulcers in the United States. 

National Center for Biotechnology Information (NCBI) estimates that in the United States alone 30,000 to 75,000 cases of corneal ulcers occur each year, and about 12.2% of corneal transplants are performed to treat infectious keratitis.

Amplify Eyecare Santa Clarita

Is a corneal ulcer an eye emergency?

A corneal ulcer is an eye emergency that should be treated as soon as possible because it can lead to vision loss. Therefore, you should see our optometrist or ophthalmologist as soon as you start exhibiting symptoms. Call our eye doctor right away at (661) 775-1860 if you:

  • Have persistent discharge from the eye
  • Develop blurry vision suddenly
  • Have eye pain and redness that persist for 3 days
  • Have a white mark on the cornea and a red eye

What are the symptoms of a corneal ulcer?

Corneal ulcers are characterized by the following symptoms:

  • Eye pain and soreness
  • Reduced visual acuity
  • A feeling of something in your eye
  • Pus or other discharge
  • Blurred vision
  • Light sensitivity
  • Swelling of the eyelids
  • Red, teary, bloodshot eye
  • Corneal ulcers only occur in one eye
  • White mark on your cornea you might or might not be able to see when you look in the mirror
What are the symptoms of a corneal ulcer?
What causes a corneal ulcer?

What causes a corneal ulcer?

There are many causes of corneal ulcers, including bacterial, viral, fungal, or parasitic infections.

Acanthamoeba keratitis
Acanthamoeba keratitis occurs in people who wear contact lenses. Use of contact lenses is the leading cause of corneal ulcers in the United States. The risk of it occurring is higher among those who make their own cleaning solutions, clean their contact lenses with tap water, or swim with contact lenses, especially in freshwater lakes and rivers.

Fungal keratitis
Fungal keratitis can result from corneal injuries involving fungus-contaminated plant material, for example getting hit in the eye with a tree or plant. Additionally, people with suppressed immune systems and in some cases contact lens wearers who are not careful about proper maintenance may suffer from fungal keratitis.

Herpes simplex keratitis
Another type of corneal ulcer is herpes simplex keratitis, a serious viral infection caused by herpes simplex virus (HSV). Type I is the type of herpes virus that is known to cause eye infections. This virus is highly contagious and is usually spread through skin contact. This is also very common in the United States.

What causes a corneal ulcer?

Diagnosis of a corneal ulcer

  • In the case of suspected fungal infections or Acanthamoeba, confocal microscopy may assist in the diagnosis.
  • Culture of a corneal infection must be done to determine the exact cause of infection so that an accurate diagnosis is made prior to treatment. 
  • Corneal topography can be performed to determine whether a patient has fungal keratitis.
  • If the corneal ulcer is acute and superficial, fluorescein stain testing may only be necessary.
  • Detailed imaging using anterior segment Ocular Coherence Tomography (AS OCT) is  an important tool in the evaluation and management of corneal ulcers, providing a detailed evaluation in a non-contact and safe way.

Who is at risk of a corneal ulcer?

  • Agricultural workers may be more likely to develop fungal keratitis due to soil and plant exposure
  • Sleeping in contact lenses or having poor contact lens hygiene puts contact lens wearers at higher risk of Pseudomonas Keratitis.
  • Those who wear contact lenses in freshwater or wash them with water rather than contact lens solution are at risk for Acanthamoeba keratitis.
  • Those with a cold sore, chicken pox, or shingles
  • Patients with dry eye syndrome who use steroid eye drops
  • Those whose eyelids do not function normally
  • Diabetics or immunosuppressed patients are more prone to corneal ulcers. An endocrinologist should be consulted if the sugar levels are out of control since this can interfere with corneal wound healing.

Prevention of a corneal ulcer

  • A corneal ulcer is most commonly caused by poor cleaning and handling of contact lenses. You must therefore use, disinfect, and store your contact lenses properly.
  • You must always avoid wearing contact lenses while showering, swimming, or performing any activity that may cause your eyes to become wet.
  • You should also avoid wearing contact lenses for long periods of time. When you get home from work, you can take out your contact lenses and switch to eyeglasses.
  • An eye injury can lead to corneal ulcer. Therefore, it is advised to wear protective glasses if you are a construction worker, plumber, welder or an electrician.
  • Keep eye makeup to a minimum because it can clog your eyes and cause infection.
  • To reduce the risk of corneal ulcers, you should never share makeup, towels, or eye drops with anyone.
What are the symptoms of a corneal ulcer?
What causes a corneal ulcer?

Treatment of a corneal ulcer

Treatment of corneal ulcer depends on the cause of the infection, which will be determined through a culture test of your cornea.

Antibiotics
If the corneal ulcer is not severe and is not a threat to your vision, antibiotic drops such as fluoroquinolones (moxifloxacin, besifloxacin, gatifloxacin) and bacitracin or erythromycin may be prescribed. It has now been shown in multiple studies that fluoroquinolones are effective in treating bacterial keratitis.

Culture
Culture testing of the cornea is recommended for corneal ulcers that are large and causing severe symptoms. The reason that this is important is that common ocular pathogens are becoming more and more resistant to antibiotics. Another reason is to determine the right antibiotic to treat your specific infection. Additionally, it should be done before the treatment begins.
After the infection has cleared, depending on how severe your infection was, our eye doctor may prescribe an anti-inflammatory eye drop or steroid eye drop to reduce inflammation and decrease corneal scarring.

Amniotic membrane
Surgery may be required for patients who are not responsive to medication. An amniotic membrane graft may be applied under sterile conditions to promote healing. In cases of severe scarring, a corneal transplant may be performed to replace diseased corneal tissue with healthy tissue from a donor.

Bandage contact lenses
Bandage contact lenses can be an effective way at treating corneal ulcers by both protecting the wound and enabling healing.

Dr. Garbus, FAAO cartoon

Visit Amplify EyeCare Santa Clarita for an emergency eye exam

A corneal ulcer is a wound that appears on the surface of your cornea caused primarily by infection, but not necessarily. An ulcer can also form on your cornea if you have an injury to your cornea. Anyone can develop a corneal ulcer, regardless of age, however contact lens wear is the primary cause of corneal ulcers in the US. The severity of corneal ulcers can vary depending on their cause. A corneal ulcer is an eye emergency that should be treated as soon as possible because it can lead to vision loss. Because of the potential for a corneal ulcer to lead to vision loss, you should see our optometrist at Amplify EyeCare Santa Clarita as soon as you start exhibiting symptoms. Patients searching for advanced medical eye care visit our clinic from all over California, and we are proud to be a leading provider of medical eye care services for patients from Santa Clarita, Palmdale, Lancaster, and San Fernando Valley.

Testimonials


  • My eight year old daughter was terrified to go to the eye doctor for fear of her eyes being dilated. The doctor was SO KID friendly! He immediately made her comfortable by engaging her in conversation. It was a geat experience.


    Joya B.

  • Dr. Garbus spent an amazing amount of time to solve my very complicated visual problems. Over the years he has continually achieved results beyond what others felt possible. He is always up to date on the latest science. He is great!


    Dolores K.

  • Family Vision Care Valencia makes it so easy. Staff is knows what they are doing and Dr. Garbus is thorough and kept me well informed during the exam.


    Kristy B.

  • I have been coming to Family Vision Center for almost 20 years. Dr. Garbus has been able to help my vision when other doctors could not. Now my kids see him as well. I highly recommend this office!


    Autumn C.

  • The Doctor is very good. I felt on this visit he seemed rushed. I had questions to ask him but he was already with another patient. I still do not know if my eyes are the same , worse, or better.


    Howard B.

Testimonials


My eight year old daughter was terrified to go to the eye doctor for fear of her eyes being dilated. The doctor was SO KID friendly! He immediately made her comfortable by engaging her in conversation. It was a geat experience.


Joya B.

Dr. Garbus spent an amazing amount of time to solve my very complicated visual problems. Over the years he has continually achieved results beyond what others felt possible. He is always up to date on the latest science. He is great!


Dolores K.

Family Vision Care Valencia makes it so easy. Staff is knows what they are doing and Dr. Garbus is thorough and kept me well informed during the exam.


Kristy B.

I have been coming to Family Vision Center for almost 20 years. Dr. Garbus has been able to help my vision when other doctors could not. Now my kids see him as well. I highly recommend this office!


Autumn C.

The Doctor is very good. I felt on this visit he seemed rushed. I had questions to ask him but he was already with another patient. I still do not know if my eyes are the same , worse, or better.


Howard B.

All the staff is friendly, helpful and knowledgeable, and has been for all the years I have been going there.


Mary Ann H.
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