Medicines for Corneal ulcer

What it is

A corneal ulcer is an open sore (an area of tissue loss) on the cornea — the clear window at the front of the eye — usually caused by an infection. It is a serious eye condition, because the cornea is essential for clear vision, and an ulcer (particularly if it involves infection deep in the cornea) can threaten sight and, if not treated promptly, can lead to scarring or more serious damage. Corneal ulcers are most commonly caused by infection — bacterial, and sometimes viral, fungal, or, rarely, from certain other organisms — that gets into the cornea, often through a break in its surface. An important risk factor is contact lens wear, especially if lenses are worn overnight, for too long, or with poor hygiene, which significantly increases the risk of a corneal infection and ulcer. Other risk factors include eye injury (such as a scratch or foreign body), a very dry eye, or conditions affecting the eye surface. Symptoms include a painful, red eye (often severe), a feeling of something in the eye, watering, sensitivity to light, blurred vision, discharge, and sometimes a visible white or grey spot on the cornea. Because a corneal ulcer can rapidly threaten sight, it is a medical emergency needing urgent assessment and treatment.

How it is treated

A corneal ulcer needs urgent eye assessment and treatment, as prompt treatment protects sight. Anyone with a painful red eye and the features above — especially a contact lens wearer — should seek urgent eye care. The eye specialist examines the eye, and often takes samples (scrapes) from the ulcer to identify the responsible organism and guide treatment. Treatment is directed at the cause: intensive antibiotic eye drops for a bacterial ulcer (often given very frequently, sometimes hourly including overnight at first), or antiviral, antifungal or other specific treatment depending on the cause, along with treatments to ease pain and support healing. Contact lens wear is stopped, and lenses and cases are usually discarded. Close monitoring and follow-up are important to ensure the ulcer is healing and to manage any complications, and severe or non-healing ulcers may need more intensive or specialist treatment. After healing, some ulcers leave a scar that can affect vision, and further treatment (occasionally including a corneal transplant) is sometimes needed. Preventing corneal ulcers is important, especially for contact lens wearers — through good lens hygiene, not sleeping in lenses unless designed for it, not over-wearing lenses, and seeking prompt care for a red or painful eye. The reassuring message is that a corneal ulcer, though a serious, sight-threatening condition, is treatable with prompt, intensive treatment — so a painful red eye, particularly in a contact lens wearer, needs urgent assessment.