Corneal ulcers and infections

Corneal Ulcers and Infections
Table of Contents
Alternative names Definition Causes, Incidence and Risk Factors	Prevention Symptoms Signs & Tests Treatment	Expectations Complications Calling Your health care provider
Alternative Names bacterial keratitis; fungal keratitis; acanthamoeba keratitis; herpes zoster ophthalmicus; herpes simplex keratitis
Definition A non-penetrating erosion, or open sore in the outer layer of the cornea, the transparent area at the front of the eyeball. See also corneal injury.
Causes, Incidence and Risk Factors Corneal ulcers are most commonly caused by an infection of bacteria, viruses, fungi, or amebas. Other causes are abrasions or foreign bodies, inadequate eyelid closure, severe dry eyes, severe allergic eye disease, and various inflammatory disorders. Bacterial keratitis may be caused by numerous organisms. Contact lens wear, especially soft contact lenses worn overnight, may be a precipitating factor. Herpes simplex keratitis is a serious viral infection. It may have recurrences that are triggered by stress, exposure to sunlight, or any condition, disease or treatment which impairs the immune system. Corticosteroid therapy, given in the presence of herpetic keratitis, has been associated with more extensive ulcers. Fungal keratitis can occur after corneal injury involving plant material, in an agriculture setting, or in immunocompromised (immunosuppressed) people. Acanthamoeba keratitis occurs in contact lens users, especially those who use homemade cleaning solutions. Risk factors are dry eyes, severe allergies, history of inflammatory disorders, contact lens wear, immunosuppression, prolonged exposure to sunlight, and infection.
Prevention Prompt, early attention by an ophthalmologist to any eye infection may prevent ulceration. Rigorous attention to cleanliness while handling contact lenses and avoidance of overnight wearing of contact lenses may prevent infection or ulceration.
Symptoms eye pain impaired vision eye redness (scleral injection) white patch on the cornea sensitivity to light (photophobia) tearing, increased Additional symptoms that may be associated with this disease: facial swelling eye burning, itching & discharge
Signs & Tests visual acuity refraction test tear test slit-lamp examination pupillary reflex response keratometry (measurement of the cornea) scraping of ulcer for analysis or culture fluorescein stain of the cornea Blood tests to check for inflammatory disorders may also be indicated.
Treatment Treatment of corneal ulcers and infections depends upon the cause and should be treated as soon as possible to prevent further injury to the cornea. Antibiotic, antiviral, or antifungal eye drops are prescribed as soon as the type of ulcer has been identified. Corticosteroid eye drops may be used to reduce inflammation in certain conditions, but they should be avoided with herpes infections.
Expectations (Prognosis) Untreated, a corneal ulcer or infection can permanently damage the cornea. The untreated corneal ulcer may also perforate the interior of the eye, resulting in a spread of infection, increasing the risk of permanent visual impairment.
Complications corneal clouding corneal scarring severe scarring
Calling your doctor/health care provider Call your health care provider if impaired vision or eye pain occur.