Corneal ulcers and infections

Definition

The cornea is the clear tissue at the front of the eye. A corneal ulcer is an open sore in the outer layer of the cornea. It is often caused by infection. At first, a corneal ulcer may seem like conjunctivitis, or pink eye.

Alternative Names

Bacterial keratitis; Fungal keratitis; Acanthamoeba keratitis; Herpes simplex keratitis

Causes

Corneal ulcers are most commonly caused by an infection with bacteria, viruses, fungi, or a parasite.

Corneal ulcers or infections may also be caused by:

Wearing contact lenses, especially soft contacts that are left in overnight, may cause a corneal ulcer.

Symptoms

Symptoms of infection or ulcers of the cornea include:

Exams and Tests

Your health care provider may do the following tests:

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

Treatment

Treatment for corneal ulcers and infections depends on the cause. Treatment should be started as soon as possible to prevent scarring of the cornea.

If the exact cause is not known, you may be given antibiotic drops that work against many kinds of bacteria.

Once the exact cause is known, you may be given drops that treat bacteria, herpes, other viruses, or a fungus. Severe ulcers sometimes require a corneal transplant.

Corticosteroid eye drops may be used to reduce swelling and inflammation in certain conditions.

Your provider may also recommend that you:

Outlook (Prognosis)

Many people recover completely and have only a minor change in vision. However, a corneal ulcer or infection can cause long-term damage and affect vision.

Possible Complications

Untreated corneal ulcers and infections may lead to:

When to Contact a Medical Professional

Call your provider if:

Prevention

Things you can do to prevent the condition include:

References

Austin A, Lietman T, Rose-Nussbaumer J. Update on the management of infectious keratitis. Ophthalmology. 2017;124(11):1678-1689. PMID: 28942073 pubmed.ncbi.nlm.nih.gov/28942073/.

Aronson JK. Contact lenses and solutions. In: Aronson JK, ed. Meyler's Side Effects of Drugs. 16th ed. Waltham, MA: Elsevier B.V.; 2016:580-581.

Azar DT, Hallak J, Barnes SD, Giri P, Pavan-Langston D. Microbial keratitis. In: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. 9th ed. Philadelphia, PA: Elsevier; 2020:chap 113.

Cioffi GA, Liebmann JM. Diseases of the visual system. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 395.

Efron N. Corneal staining. In: Efron N, ed. Contact Lens Complications. 4th ed. Philadelphia, PA: Elsevier; 2019:chap 18.

Guluma K, Lee JE. Ophthalmology. In: Walls RM, Hockberger RS, Gausche-Hill M, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 9th ed. Philadelphia, PA: Elsevier; 2018:chap 61.


Review Date: 8/18/2020
Reviewed By: Franklin W. Lusby, MD, ophthalmologist, Lusby Vision Institute, La Jolla, CA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
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