Corneal ulcers and infections

Causes and Risks:
Corneal ulcers are most commonly caused by an infection of bacteria, viruses, fungi, or amebas. Other causes are abrasions or foreign bodies, inadequate eyelid closure, severe dry eyes, severe allergic eye disease, and various inflammatory disorders.

Bacterial keratitis may be caused by numerous organisms. Contact lens wear, especially soft contact lenses worn overnight, may be a precipitating factor. Herpes simplex keratitis is a serious viral infection. It may have recurrences that are triggered by stress , exposure to sunlight, or any condition, disease or treatment which impairs the immune system. Corticosteroid therapy, given in the presence of herpetic keratitis, has been associated with more extensive ulcers .

Fungal keratitis can occur after corneal injury involving plant material, in an agriculture setting, or in immunocompromised ( immunosuppressed ) people. Acanthamoeba keratitis occurs in contact lens users, especially those who use homemade cleaning solutions.

Risk factors are dry eyes, severe allergies , history of inflammatory disorders, contact lens wear, immunosuppression , prolonged exposure to sunlight, and infection.

Prevention:
Prompt, early attention by an ophthalmologist to any eye infection may prevent ulceration. Rigorous attention to cleanliness while handling contact lenses and avoidance of overnight wearing of contact lenses may prevent infection or ulceration.

Symptoms:

Additional symptoms that may be associated with this disease:



Signs and Tests:

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

Treatment:
Treatment of corneal ulcers and infections depends upon the cause and should be treated as soon as possible to prevent further injury to the cornea. Antibiotic, antiviral, or antifungal eye drops are prescribed as soon as the type of ulcer has been identified. Corticosteroid eye drops may be used to reduce inflammation in certain conditions, but they should be avoided with herpes infections.

Prognosis:
Untreated, a corneal ulcer or infection can permanently damage the cornea. The untreated corneal ulcer may also perforate the interior of the eye, resulting in a spread of infection, increasing the risk of permanent visual impairment.

Complications:

  • corneal clouding
  • corneal scarring
  • severe scarring



Call Your Healthcare Provider:
Call your health care provider if impaired vision or eye pain occur.


This is an illustration of a cross-section and frontal view of the eye.



Herpes virus, the cause of cold sores, can also infect the membranes of the eye. Herpes simplex keratitis causes inflammation of the white of the eye and can damage the cornea. Corneal damage has occurred, and is stained green (about 12:00 o'clock on the iris) with a dye called fluorscein. Some of the dye is pooled along the lower lid margin. Herpes infection in the eye can cause corneal scarring with vision loss.