Anyone who experiences the symptoms of a light-sensitive, red, painful and watery eye could possibly be suffering from a corneal ulcer (ulcus corneae). With these signs, it is therefore advisable to consult an ophthalmologist as soon as possible.
What is a corneal ulcer?
With a corneal ulcer, progressive melting occurs at the edge of the cornea, which is triggered by infectious. According to abbreviationfinder, the specific pathogens can penetrate through a superficial injury to the cornea; the result is a reddened and irritated eye.
Since the cornea is extremely important for the ability to see, a corneal ulcer must be treated immediately by an ophthalmologist. Vision can be severely affected by a corneal ulcer because the refractive power of the cornea is disrupted by such an irregularity.
Due to the sensitive supply of nerves to the eye, an injury to the cornea can usually be noticed through pain and uncontrollable tear flow. A corneal ulcer can eventually develop as a result of an injury to the cornea.
Causes
The cause of a corneal ulcer is due to an infection caused by a specific pathogen.
Certain factors can promote the formation of a corneal ulcer, such as dry eyes, frequent wearing of soft contact lenses and pre-existing injuries to the cornea on its surface.
Inflammation of the lacrimal sac or the cornea can also be beneficial. Additional risk factors are diabetes mellitus, rheumatic diseases or old age.
Symptoms, Ailments & Signs
Symptoms of a corneal ulcer can develop acutely and worsen drastically. In general, they resemble those of corneal inflammation. The most striking here are strong and persistent eye pain. Another typical sign is a noticeable reddening of the affected eye. Those affected also complain of clearly impaired vision.
There is also increased sensitivity to light. The symptoms increase when the person concerned looks directly into the light. The occurrence of a foreign body sensation in the eye is also striking in the case of a corneal ulcer. Most patients also complain of visual disturbances. The affected person can no longer control the flow of tears. The eyes keep watering. In many cases, a corneal ulcer also leads to a significantly swollen conjunctiva
The disease can also be easily identified directly on the cornea. Thus the ulcer itself appears as a grey-whitish opacity. The center is thinned and the edges are raised. If left untreated, these symptoms usually get much worse on their own. As an extreme consequence, the complete blindness of the eye at this stage can also be a sign of the corneal ulcer.
Diagnosis & History
The diagnosis of a corneal ulcer is not difficult for the specialist based on the anamnesis of the person concerned. If the factors mentioned above also come into play, this can indicate damage to the cornea.
The corneal ulcer can be clearly recognized by an examination with a so-called slit lamp, which the doctor carries out if there is any suspicion. The tear ducts are often rinsed to clean them or to prevent narrowing. In order to be able to prepare and adapt the subsequent therapy, the ophthalmologist takes a swab of the conjunctiva and the corneal ulcer.
This is how the responsible pathogens for the corneal ulcer are identified. In order to avoid a bad course, the corneal ulcer should be examined or treated immediately after the symptoms appear. Within a few hours, vision can deteriorate so much that a kind of scar remains on the cornea after the therapy. As a result, vision can be permanently impaired. The most fatal course would be blindness in the affected eye.
Complications
A corneal ulcer can cause an infection in the eye, which of course can also cause various complications. At the first signs of aggravation, a doctor should definitely be consulted so that any consequential damage can be recognized early and treated accordingly. An infection usually manifests itself in a severely reddened eye.
A significantly increased tear flow can also be an indication of an infection. In such a case, affected persons should consult a doctor directly so that the inflammation can be alleviated quickly and effectively with appropriate medication. However, if medical treatment is not given at this point, there is a risk of a significant deterioration.
In particularly bad cases, it can even lead to the formation of pus, so that a doctor should be consulted immediately at the latest. Otherwise, the cornea can be permanently damaged, resulting in permanent consequential damage to the eye. Therefore, a corneal ulcer should by no means be taken lightly.
If this clinical picture remains without any treatment, there is a risk of serious complications. If you want to avoid these complications early on, you should see a doctor as soon as the first signs of inflammation appear. With the right medication, an infection in the eye can be treated effectively and quickly.
When should you go to the doctor?
If symptoms such as eye pain, sensitivity to light, and red eyes are noticed, a corneal ulcer may be the cause. A doctor’s visit is indicated if the symptoms appear suddenly and last longer than two to three days. If other symptoms appear, the ophthalmologist must be consulted on the same day. A corneal ulcer can become so severe within a few hours that a scar remains after treatment.
To avoid scarring or even blindness, the condition must be promptly evaluated and treated. People who have had dry eyes for a long time or who wear soft contact lenses are particularly susceptible to a corneal ulcer. People with rheumatic diseases or diabetes mellitus are also among the risk groups and should see a doctor immediately if they experience the symptoms mentioned. If pus forms, the vision suddenly decreases sharply or there is severe pain, the person concerned must be taken to the hospital. Children should be taken to the pediatrician if there are signs of a corneal ulcer.
Treatment & Therapy
Therapy of the corneal ulcer is mainly carried out locally; constricted tear ducts are flushed directly. Anyone who wears contact lenses should definitely refrain from wearing them until they have completely healed.
Antibiotic drops are prescribed to combat the pathogens. If the middle eye skin is inflamed at the same time, treatment with antibiotics in tablet form must be carried out. If the corneal ulcer is very advanced or the cornea has already been perforated, an operation is performed in which the cornea is transplanted. It is possible that further operations will have to follow if the transplanted cornea cannot heal immediately.
If there is still no improvement after conservative therapy with eye drops and tablets, an operation may be necessary. Such treatment of a corneal ulcer sometimes extends over several weeks. In any case, the transplantation must be carried out before the pathogens migrate to the edge of the cornea so that they cannot infect the new cornea again.
If the corneal ulcer is rheumatic, it often has to be operated on. However, there is a risk of new rheumatic ulcers forming. If a scar remains after conservative therapy, which severely impairs vision, a corneal transplant can also be carried out.
Outlook & Forecast
The prognosis of the corneal ulcer is evaluated according to the time when treatment can be started. In acute situations, there can be a significant increase in symptoms within a few hours because the ulcer is growing unabated. The later it is possible to start therapy, the more difficult the further course of the disease and the best possible chance of recovery.
In severe cases, the patient is at risk of permanent vision impairment or blindness. This applies in particular if the patient does not seek medical care or the therapy carried out is unsuccessful. In an emergency operation, a transplant of the cornea must be carried out if possible so that there is a chance of improving the vision. Alternatively, the patient is threatened with blindness.
If there is additional inflammation of the inside of the eye, a significant delay in the healing process is to be expected. The pathogens have already spread further in the eye and need to be treated. If drug treatment takes place as quickly as possible, a rapid reduction in symptoms can be observed in most cases. The germs are killed and transported out of the organism. The ulcer regresses completely and recovery is possible.
If there is damage to the retina, this can lead to permanent clouding of vision or permanent impairment of natural vision.
Prevention
The corneal ulcer can be prevented if damage to the cornea is avoided, for example by early treatment of insufficient eyelid closure. In addition, careful hygiene is advisable when wearing contact lenses so that no foci of germs can form there; both on the lenses and in the storage boxes. In general, contact lenses should not be worn too long during the day and should definitely be removed before going to sleep.
Aftercare
In most cases, patients with a corneal ulcer have very few measures and options for direct follow-up care. The first priority for this disease is to treat it promptly to stop the ulcer from spreading further through the sufferer’s body. The earlier the disease is recognized by a doctor, the better the further course is, so that the patient should consult a doctor as soon as the first symptoms of the disease appear.
Whether this disease will lead to a reduced life expectancy cannot be predicted in general. In the worst case, the person affected can become blind. If the disease is treated by taking antibiotics, the person concerned should ensure that the medication is taken regularly and that the dosage is correct.
It should also be noted that antibiotics should not be taken together with alcohol. Eye drops should also be used regularly. In severe cases, however, surgery is necessary to relieve the symptoms. After such an operation, the region of the eyes should be particularly well protected. The further course depends very much on the time of diagnosis, so that no general prediction can be made.
You can do that yourself
A corneal ulcer can be prevented by various hygiene measures. During treatment, however, the patient is always dependent on treatment by a doctor in order to avoid complete loss of vision.
If the patient is dependent on contact lenses, they should always be disinfected. It is also advisable to take out the contact lenses before going to sleep and not to keep them on your eyes. Corneal ulcers are usually treated with eye drops or antibiotics. The person concerned must ensure that they are taken regularly and possibly do without other medicines if they would interfere with the effect of the antibiotics. However, it is advisable to consult a doctor. Medications should never be discontinued or changed without consulting a doctor.
A corneal ulcer can also lead to blindness. In this case, psychological complaints and depression must be prevented. The help of friends and acquaintances can make the patient’s everyday life much easier and also prevent psychological upsets. Talking to other sufferers is also helpful. Corneal transplantation can prevent blindness in severe cases.
