Conditions We Treat
Corneal Ulcer
A corneal ulcer is an open sore on the cornea — the clear front window of the eye — most often caused by an infection. It is a medical emergency: without prompt treatment an ulcer can scar the cornea, thin or even perforate it, and permanently affect vision. If you have a painful red eye with blurred vision, do not wait — call us or seek care right away.
Contact lens wearers, take note: sleeping in lenses, poor hygiene, and over-wearing lenses are leading causes of corneal ulcers. Any red, painful eye in a contact lens wearer should be treated as an ulcer until proven otherwise — remove the lens and be seen promptly.
What causes a corneal ulcer?
Most ulcers are infectious and can be caused by bacteria, fungi, viruses, or Acanthamoeba (a parasite linked to water exposure in contact lens wearers). Common risk factors include contact lens wear, an eye injury or scratch, severe dry eye, and other ocular surface disease. Identifying the organism guides treatment, so cultures or scrapings of the cornea are often taken.
Symptoms
- Significant eye pain and redness
- Light sensitivity and tearing or discharge
- Blurred or decreased vision
- A white or gray spot on the normally clear cornea
- A persistent feeling that something is in the eye
How we treat corneal ulcers
Treatment is urgent and tailored to the cause and severity:
- Intensive topical antibiotics — antibiotic drops are often started very frequently, sometimes around the clock, to control the infection quickly.
- Fortified antibiotics — for larger or central ulcers, we use specially compounded, higher-concentration drops, and may combine agents to cover a broad range of bacteria. Antifungal, antiviral, or anti-amoebic therapy is added when those organisms are suspected.
- Supportive care — dilating drops for comfort, stopping contact lens wear, and sometimes oral medications. We follow ulcers closely, often daily at first, to be sure they are improving.
- Amniotic membrane transplant — for ulcers that are slow to heal, large, or at risk of scarring or thinning, we place a thin layer of amniotic membrane on the eye. This natural tissue is rich in healing and anti-inflammatory factors; it reduces inflammation and scarring and helps the surface heal smoothly. It can be applied as a self-retained device in the office or secured to the eye, depending on the situation.
Once the infection is controlled, we focus on the ocular surface to limit scarring and protect your vision. Severe, perforating, or scarring ulcers may need additional surgical care, which we coordinate promptly. The most important step is early treatment — a corneal ulcer caught early usually does well.
This page is for general education and is not medical advice. If you have symptoms or concerns, please request an appointment for an evaluation.