Keratitis - Corneal Ulcers

A corneal ulcer is a lesion on the cornea that is usually caused by an infection. The cornea is the clear window on the front of the eye that covers the colored iris and pupil.

What is going on in the body?

Corneal ulcers generally form when the cornea is damaged in some way. The break in the cornea allows organisms to enter and cause an infection. The organisms may be a type of bacteria, virus, or fungus. Allergies or other eye conditions may also cause corneal ulcers.

What are the causes and risks of the infection?

Herpes simplex infection is the most common cause of corneal ulcers in the United States. The virus that causes chickenpox and shingles can also cause corneal ulcers. Many times, bacterial or fungal infections lead to corneal ulcers.

Other causes of corneal ulcers include:

What are the signs and symptoms of the infection?

Symptoms of a corneal ulcer include:

How is the infection diagnosed?

Diagnosis of a corneal ulcer begins with a medical history and physical exam. A slit lamp exam uses a microscope and a rectangular light source to examine the cornea. Often, the cornea is stained with a dye called fluorescein. Scrapings from the cornea may be sent to a lab to determine if a fungus or bacteria is present.

What can be done to prevent the infection?

People who wear contacts should clean them as directed and remove them when sleeping. Individuals should wear safety glasses to prevent injury and contamination of the eyes in high-risk situations. Eye makeup and brushes should not be shared. Effective treatment of allergies may prevent some corneal ulcers.

What are the long-term effects of the infection?

If corneal ulcers are not treated, the person may have corneal scarring, permanent visual impairment, or even a hole in the cornea.

What are the risks to others?

A corneal ulcer is not contagious. However, an underlying infection may be spread from one person to another.

What are the treatments for the infection?

If the corneal ulcer is caused by bacteria, antibiotics may be given. If the ulcer is serious, hospitalization and intravenous (IV) antibiotics may be necessary. Antifungal drops or oral pills can be used for fungal infections. For infection with herpes simplex or other viruses, antiviral eye drops or oral pills may be given.

What are the side effects of the treatments?

Medicines used to treat corneal ulcers may cause stomach upset, rash, allergic reactions, and other side effects.

What happens after treatment for the infection?

If treatment is started within hours of symptoms, the individual generally has no permanent eye damage.

How is the infection monitored?

Any new or worsening symptoms should be reported to the healthcare provider.

Author:William Stevens, MD
Date Written:
Editor:Crist, Gayle P., MS, BA
Edit Date:09/30/01
Reviewer:Eileen McLaughlin, RN, BSN
Date Reviewed:09/14/01