Corneal ulcers and infections
Definition
The cornea is the clear (transparent) tissue at the front of the eye. A corneal ulcer is an erosion or open sore in the outer layer of the cornea. It is often caused by infection.
See also: Corneal injury
Alternative Names
Bacterial keratitis; Fungal keratitis; Acanthamoeba keratitis; Herpes simplex keratitis
Causes, incidence, and risk factors
Corneal ulcers are most commonly caused by an infection with bacteria, viruses, fungi, or a parasite.
Acanthamoeba keratitis occurs in contact lens users, especially in people who make their own homemade cleaning solutions.
Fungal keratitis can occur after a corneal injury involving plant material, or in people with a suppressed immune system.
Herpes simplex keratitis is a serious viral infection. It may cause repeated attacks that are triggered by stress, esposure to sunlight, or any condition that impairs the immune system.
Corneal ulcers or infections may also be caused by:
Eyelids that do not close all the way, such as with
Bell's palsyForeign bodies in the eye
Scratches (abrasions) on the eye surface
Severely dry eyes
Severe allergic eye disease
Various inflammatory disorders
Contact lens wear, especially soft contact lenses worn overnight, may cause a corneal ulcer.
References
Sharma R, Brunette DD. Ophthalmology. In: Mark JA, ed. Rosen's Emergency Medicine: Concepts and Clinical Practice. 7th ed. Philadelphia, Pa: Mosby Elsevier;2009:chap 69.
McLeod SD. Bacterial keratitis. In: Yanoff M, Duker JS, eds. Ophthalmology. 3rd ed. St. Louis, Mo: Mosby Elsevier;2008:chap 4.12.
McLeod SD. Fungal keratitis. In: Yanoff M, Duker JS, eds. Ophthalmology. 3rd ed. St. Louis, Mo: Mosby Elsevier;2008:chap 4.13.
Tuli SS. Herpes simplex keratitis. In: Yanoff M, Duker JS, eds. Ophthalmology. 3rd ed. St. Louis, Mo: Mosby Elsevier;2008:chap 4.15.
Soukiasian S. Peripheral ulcerative keratitis. In: Yanoff M, Duker JS, eds. Ophthalmology. 3rd ed. St. Louis, Mo: Mosby Elsevier;2008:chap 4.16.
Bouchard CS. Noninfectious keratitis. In: Yanoff M, Duker JS, eds. Ophthalmology. 3rd ed. St. Louis, Mo: Mosby Elsevier;2008:chap 4.17.
Review Date: 7/28/2010
Reviewed By: Linda J. Vorvick, MD, Medical Director, MEDEX Northwest Division of Physician Assistant Studies, University of Washington School of Medicine; and Franklin W. Lusby, MD, Ophthalmologist, Lusby Vision Institute, La Jolla, California. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. Copyright 2004 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
Alternative Names
Bacterial keratitis; Fungal keratitis; Acanthamoeba keratitis; Herpes simplex keratitis
Symptoms
Symptoms of infection or ulcers of the cornea include:
Signs and tests
Blood tests to check for inflammatory disorders may also be needed.
References
Sharma R, Brunette DD. Ophthalmology. In: Mark JA, ed. Rosen's Emergency Medicine: Concepts and Clinical Practice. 7th ed. Philadelphia, Pa: Mosby Elsevier;2009:chap 69.
McLeod SD. Bacterial keratitis. In: Yanoff M, Duker JS, eds. Ophthalmology. 3rd ed. St. Louis, Mo: Mosby Elsevier;2008:chap 4.12.
McLeod SD. Fungal keratitis. In: Yanoff M, Duker JS, eds. Ophthalmology. 3rd ed. St. Louis, Mo: Mosby Elsevier;2008:chap 4.13.
Tuli SS. Herpes simplex keratitis. In: Yanoff M, Duker JS, eds. Ophthalmology. 3rd ed. St. Louis, Mo: Mosby Elsevier;2008:chap 4.15.
Soukiasian S. Peripheral ulcerative keratitis. In: Yanoff M, Duker JS, eds. Ophthalmology. 3rd ed. St. Louis, Mo: Mosby Elsevier;2008:chap 4.16.
Bouchard CS. Noninfectious keratitis. In: Yanoff M, Duker JS, eds. Ophthalmology. 3rd ed. St. Louis, Mo: Mosby Elsevier;2008:chap 4.17.
Review Date: 7/28/2010
Reviewed By: Linda J. Vorvick, MD, Medical Director, MEDEX Northwest Division of Physician Assistant Studies, University of Washington School of Medicine; and Franklin W. Lusby, MD, Ophthalmologist, Lusby Vision Institute, La Jolla, California. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. Copyright 2004 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
Alternative Names
Bacterial keratitis; Fungal keratitis; Acanthamoeba keratitis; Herpes simplex keratitis
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, patients may start treatment with antibiotic drops that work against many kinds of bacteria.
Once the exact cause is known, drops that treat bacteria, herpes, other viruses, or a fungus are prescribed.
Corticosteroid eye drops may be used to reduce swelling and inflammation in certain conditions.
Your doctor may also recommend that you:
Avoid eye makeup
Don't wear contact lenses at all, or don't wear them at night
Take pain medications
Wear an eye patch to keep light out and help with symptoms
Wear protective glasses
Severe ulcers may need to be treated with corneal transplantation.
Expectations (prognosis)
Many people recover completely from corneal ulcers or infections, or they have only a minor change in vision.
However, a corneal ulcer or infection can cause long-term damage to the cornea and lead to a noticeable worsening of vision.
Complications
Untreated corneal ulcers and infections may lead to:
- Loss of the eye (rare)
- Severe vision loss
- Scars on the cornea
Calling your health care provider
Call your health care provider if:
References
Sharma R, Brunette DD. Ophthalmology. In: Mark JA, ed. Rosen's Emergency Medicine: Concepts and Clinical Practice. 7th ed. Philadelphia, Pa: Mosby Elsevier;2009:chap 69.
McLeod SD. Bacterial keratitis. In: Yanoff M, Duker JS, eds. Ophthalmology. 3rd ed. St. Louis, Mo: Mosby Elsevier;2008:chap 4.12.
McLeod SD. Fungal keratitis. In: Yanoff M, Duker JS, eds. Ophthalmology. 3rd ed. St. Louis, Mo: Mosby Elsevier;2008:chap 4.13.
Tuli SS. Herpes simplex keratitis. In: Yanoff M, Duker JS, eds. Ophthalmology. 3rd ed. St. Louis, Mo: Mosby Elsevier;2008:chap 4.15.
Soukiasian S. Peripheral ulcerative keratitis. In: Yanoff M, Duker JS, eds. Ophthalmology. 3rd ed. St. Louis, Mo: Mosby Elsevier;2008:chap 4.16.
Bouchard CS. Noninfectious keratitis. In: Yanoff M, Duker JS, eds. Ophthalmology. 3rd ed. St. Louis, Mo: Mosby Elsevier;2008:chap 4.17.
Review Date: 7/28/2010
Reviewed By: Linda J. Vorvick, MD, Medical Director, MEDEX Northwest Division of Physician Assistant Studies, University of Washington School of Medicine; and Franklin W. Lusby, MD, Ophthalmologist, Lusby Vision Institute, La Jolla, California. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. Copyright 2004 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
Alternative Names
Bacterial keratitis; Fungal keratitis; Acanthamoeba keratitis; Herpes simplex keratitis
Prevention
Prompt, early attention by an ophthalmologist for an eye infection may prevent ulcers from forming. Wash hands and pay very close attention to cleanliness while handling contact lenses. Avoid wearing contact lenses overnight.
References
Sharma R, Brunette DD. Ophthalmology. In: Mark JA, ed. Rosen's Emergency Medicine: Concepts and Clinical Practice. 7th ed. Philadelphia, Pa: Mosby Elsevier;2009:chap 69.
McLeod SD. Bacterial keratitis. In: Yanoff M, Duker JS, eds. Ophthalmology. 3rd ed. St. Louis, Mo: Mosby Elsevier;2008:chap 4.12.
McLeod SD. Fungal keratitis. In: Yanoff M, Duker JS, eds. Ophthalmology. 3rd ed. St. Louis, Mo: Mosby Elsevier;2008:chap 4.13.
Tuli SS. Herpes simplex keratitis. In: Yanoff M, Duker JS, eds. Ophthalmology. 3rd ed. St. Louis, Mo: Mosby Elsevier;2008:chap 4.15.
Soukiasian S. Peripheral ulcerative keratitis. In: Yanoff M, Duker JS, eds. Ophthalmology. 3rd ed. St. Louis, Mo: Mosby Elsevier;2008:chap 4.16.
Bouchard CS. Noninfectious keratitis. In: Yanoff M, Duker JS, eds. Ophthalmology. 3rd ed. St. Louis, Mo: Mosby Elsevier;2008:chap 4.17.
Review Date: 7/28/2010
Reviewed By: Linda J. Vorvick, MD, Medical Director, MEDEX Northwest Division of Physician Assistant Studies, University of Washington School of Medicine; and Franklin W. Lusby, MD, Ophthalmologist, Lusby Vision Institute, La Jolla, California. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. Copyright 2004 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
Review Date: 7/28/2010
Reviewed By: Linda J. Vorvick, MD, Medical Director, MEDEX Northwest Division of Physician Assistant Studies, University of Washington School of Medicine; and Franklin W. Lusby, MD, Ophthalmologist, Lusby Vision Institute, La Jolla, California. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. Copyright 2004 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.