The cornea is a thin, flexible film that covers the eye. It is clear, so a person can still see through it. The cornea’s job is to protect the iris. This is the circle of color that surrounds the black pupil in the center. It acts in a similar fashion to the way that the skin of the body protects the muscles, organs, and bones underneath it. But it isn’t as tough as skin is. Damaging it is quite easy, unfortunately. And if a damaged part of it isn’t cared for properly, a corneal ulcer can form.
This type of ulcer is rare. It only affects about 200,000 people annually. But if someone develops one, they have a high risk of losing part of their vision. They may even become totally blind. Because of this, it is still crucial for people to be able to recognize the symptoms of this type of ulcer. Afterward, it’s crucial to know what to do if you happen to get one.
What Is Corneal Ulcer?
A corneal ulcer is a nick, tear, scratch, or hole in the cornea. It usually happens on the surface of the cornea, but it can sometimes go all the way through it. Its shape depends on what caused it to occur.
Sometimes, a corneal ulcer starts out small and then, it grows larger. So it doesn’t have a specific size, but most of them are very small. Because of this, it often can’t be seen by the naked eye. An eye doctor has to put a special type of dye on the cornea to make the ulcer more visible before inspecting it with a microscope.
Symptoms of Corneal Ulcer
The first thing that a person will notice is redness and inflammation that looks similar to conjunctivitis. In fact, many cases of corneal ulcers worsen because a person falsely assumes that they just have conjunctivitis, so they don’t go to an eye doctor. The eyelid and surrounding tissue might swell. And there is usually a sensation that there is something stuck in the eye that rubbing or water baths won’t relieve.
If there is an infection present, then puss might begin to ooze from the corners of the eye. There also might be a circular white dot that resembles a cataract. It can grow large enough to block the pupil, which can make a person’s vision in that eye become limited.
The symptoms of a corneal ulcer are usually limited to one eye since only one eye is affected at a time from an injury or infection. However, the infection can be spread to the other eye too. This usually happens if a person has the same contact lens prescription for both eyes, so they switch the lenses back and forth.
Causes of Ulcer on the Cornea
People who wear contact lenses for longer than eight hours each day have a higher risk of an ulcer than those who only wear them periodically. But even one time of wearing contact lenses can damage the eye. Hard contact lenses (or soft contacts that have been allowed to partially dry out) can scratch or nick the cornea when a person puts them in. If the contacts haven’t been cleaned properly, they might have bacteria on them that can spread into this scratch or nick.
Some cheaper brands of contact lens cleaners don’t kill all the bacteria as they should. And if someone tries to save money by reusing their contact lens solution, the bacteria will keep spreading from their contacts to their eyes to the solution until all of them are brimming with bacteria. It is even worse if one never washes or replaces the contact lens case.
Corneal ulcers are more common in people who live in poverty stricken areas where hygiene and sanitation are limited. The condition is especially worse if they don’t wash their hands after using the toilet. The bacteria on their hands will be spread to their eyes when they rub them. This can happen to contact lens wearers who don’t wash their hands before removing or inserting their contacts too.
However, there are some cases of corneal ulcers that have nothing to do with hygiene. A person can get an eye infection because of damaging bacteria or parasites that attack the cornea just by swimming in a lake or river. The ulcers can also occur in welders, mechanics, or carpenters who don’t wear proper eye protection while they work. The dirt and debris from the machines that they use hit the cornea, and it becomes damaged.
Treatment for a Corneal Ulcer
If there is an infection present, then treating it is the first priority. This is done with topical antibiotics that must be applied directly to the eye every few hours. Sometimes, a doctor will prescribe oral antibiotics as well. If the antibiotic schedule isn’t kept, the infection can start to eat away at the cornea until it has more holes in it. Because of this, specialists consider corneal ulcer a medical emergency that often requires hospitalization.
If the ophthalmologist cannot control the infection, or the injury to the eye is just too severe, then there is a chance that a person will require a cornea transplant. The doctor removes the cornea, and then insert a new one. There are risks relating to this procedure, though. A person’s eyes may reject the new cornea. Or the infection might continue to spread. Their vision can also permanently change due to the procedure. Because of this, doctors often don’t attempt a cornea transplant unless there is no other way to save the cornea.
Some places sell over-the-counter drops and solutions that people think will work just as effectively to treat their corneal ulcer, but they don’t. There is no reliable product that can replace the expertise of a trained ophthalmologist. So it is crucial that anyone who is experiencing the symptoms of a corneal ulcer have someone drive them to the nearest hospital immediately. High-quality medications and care from a licensed physician are the only things that can save the eye.