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Pronunciations blepharitis conjunctivitis entropion keratitis keratoconus keratomalacia keratopathy mucus

A corneal ulcer is an infected open sore on the cornea.

• Contact lenses, injuries, disorders, drugs, and nutritional deficiencies can cause open sores.
• Pain, foreign body sensation, redness, tearing, and light sensitivity are common.
• Antibiotic, antiviral, or antifungal drugs are usually given as soon as possible.

Corneal ulcers may begin with a corneal injury, which then becomes infected with bacteria, fungi, or the protozoan Acanthamoeba (which lives in contaminated water). Viral ulcers (often due to a herpes virus) can be triggered to recur by physical stress or may recur spontaneously. Ulcers can also occur if a foreign object lodges in the eye or, more often, if the eye is irritated by a contact lens, especially when contact lenses are worn during sleep or are not adequately disinfected. A deficiency of vitamin A Some Trade Names
AQUASOL A
and protein may lead to the formation of a corneal ulcer. However, such ulcers are rare in the United States.

When the eyelids do not close properly, the cornea may become dry and irritated. This kind of irritation can lead to injury and the development of a corneal ulcer. Corneal ulcers may also result from in-growing eyelashes (trichiasis), an inturned eyelid (entropion), or eyelid inflammation (blepharitis).

Symptoms

Corneal ulcers cause pain, usually a feeling like a foreign object is in the eye, with aching and sensitivity to bright light and increased tear production. The ulcer often appears as a white spot on the cornea. Sometimes, ulcers develop over the entire cornea and may penetrate deeply. Pus may accumulate behind the cornea, sometimes forming a white layer at the bottom of the cornea. The deeper the ulcer, the more severe the symptoms and complications. The conjunctiva usually is bloodshot, and a mucus-like white discharge is present.

Corneal Ulcer

Corneal ulcers may heal with treatment, but they may leave a cloudy scar that impairs vision. Other complications may include deep-seated infection, perforation of the cornea, displacement of the iris, and destruction of most or all of the tissue in the eye socket.

Diagnosis

To see an ulcer clearly, a doctor may apply eye drops that contain a dye called fluorescein, which temporarily stains the ulcer and allows it to be examined more clearly.

Treatment

A corneal ulcer is an emergency that should be treated immediately.

Treatment depends on the underlying cause. For instance, antibiotic, antiviral, or antifungal drugs are usually needed immediately. Corneal transplantation (keratoplasty) is sometimes needed (see Transplantation: Corneal Transplants and Why They Usually Work).

Last full review/revision October 2008 by Melvin I. Roat, MD