Corneal Ulcer

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[source](https://www.healthline.com/health/corneal-ulcers-and-infections) Corneal ulcer is a defect of the corneal epithelium which involves the underlying stroma. It is a potentially vision-threatening ocular emergency and even with early treatment, patients can suffer significant morbidity with complications such as corneal scarring or perforation, development of glaucoma, cataracts and vision loss. Corneal ulcer can be classified as being either infective or sterile. It is infective when caused by bacteria, fungi, virus or protozoa while it is sterile when it is neuroparalytic, neurotrophic, due to vitamin A deficiency or a Mooren ulcer. Globally, corneal ulcer is considered as one of the traditional conditions that lead to blindness though it was not the case some time past. It is considered a silent epidemic in most developing countries, Hence, it is essential that this condition is rapidly recognized so that prompt treatment can be initiated and an urgent or emergent ophthalmologic evaluation arranged.

[source](https://www.healthline.com/health/eye-health/sunburned-eyes) **SIGNS AND SYMPTOMS** Most cases of corneal ulcer are due to a bacterial infection that invades the cornea often following eye injury, trauma or other damages. The characteristic presentation of bacterial keratitis includes an acutely ***painful, injected eye, often accompanied by purulent discharge, and decreased visual acuity.***The patient will often report feeling a large ***foreign body sensation*** in the eye with every blink. The cornea and/or the eyelids may be ***swollen***, and the conjunctival and episcleral vessels will be ***hyperemic and inflamed***. In severe cases, there may be a marked anterior chamber reaction, often with pus. Other causes of corneal ulcers are fungi and parasites. With molds, the ulcer has a dull gray infiltrate. Ulcers caused by yeast have better defined borders and may look similar to bacterial infections. Contact lens wearers who fail to remove their lenses before swimming significantly increase their risk of corneal ulcer from Acanthamoeba keratitis. Another cause of corneal ulcer is herpes simplex virus infection (ocular herpes), which can damage the exterior and sometimes even deeper layers of the eye's surface.

[source](https://www.coolwinks.com/blog/the-3-most-common-advantages-and-disadvantages-of-using-eye-drops/) **MANAGEMENT** Hospital admission should be considered for patients who are not likely to comply or are unable to self-administer treatment. A serologic test may be required to identify the causative organism. The main aim of treatment of bacterial keratitis is bacterial inhibition, healthy epithelialisation and prevention of complications. Treatment of fungal keratitis involves removal of the epithelium over the lesion which may enhance penetration of antifungal agents. Topical antifungals should initially be given hourly for 48 hours and then reduced as signs permit. Medical therapy of acanthamoeba keratitis at the epithelial stage is with topical fumagillin. Highly active antiretroviral therapy for associated AIDS may also help resolution. Management of corneal abrasions involve exclusion of foreign bodies, prevention of infection, promoting epithelial healing and pain relief. Patching the affected eye also assists with epithelial healing and pain relief. In any case, the recommendation is to seek prompt and immediate healthcare by seeking out your optometrist or ophthalmologist as soon as you notice any of the symptoms already discussed above.

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