The cornea is the transparent front part of the eye that covers the iris, pupil, and anterior chamber. The cornea refracts light entering the eye, and accounts for approximately two-thirds of the eye's total optical power.
Ocular trauma and corneal ulceration are significant causes of corneal blindness that are often underreported but may be responsible for 1.5–2.0 million new cases of monocular blindness every year. Corneal blindness is more commonly seen in children. Worldwide, 1.5 million children are blind due to corneal diseases, and another 5 million are visually disabled.
Injury or infection in the cornea can cause damage to the outermost layer of the cornea (epithelium). Break in continuity of the corneal epithelium is called corneal ulcer. It is usually associated with swelling of the cornea (edema) and tissue reaction (inflammation). Infections of the cornea by virus, bacteria and fungus are the most common causes of corneal ulcer.
• Chronic unhygienic contact lens wear • Wearing contact lenses for more than 12 hours a day • Not cleaning the contact lenses • Sleeping overnight with contact lenses on • Injury in the eye • Diabetes mellitus • Alcoholism • Immune-deficiency conditions eg.HIV/AIDS, systemic steroid intake..etc. • Nutritional deficiency conditions • Viral infections eg.herpes zoster/simplex.etc. • Poor hygiene
Affected eye will show below mentioned complaints: • Pain • Redness • Dimness of vision • Inability to open eyes in bright light • Injury in the eye • Watering • Swelling of eye-lids
Rush to the nearest ophthalmologist. If left untreated or if treatment is delayed, these may lead to permanent damage to cornea and loss of vision. What all tests do I need to undergo, if I am diagnosed as having corneal ulcer ? • The doctor will examine your eye and tell you what tests are needed. • Corneal scrapping is an examination of the infected tissue that is taken from the eye. The material from the corneal ulcer is subject to following tests : • Gram staining • KOH staining • Special stains • Culture & sensitivity-To know culprit organisms & sensitivity of various drugs on it • Corneal biopsy- it is the definitive diagnostic test for corneal ulcers
• Corneal perforation • Glaucoma • Corneal scarring • Infection Ultimately, the patient may lose vision if the corneal ulcer is untreated.
Treatment of corneal infections can often be long, lasting for few weeks to few months. It is important that you continue the treatment as per your doctor's suggestion . Strict adherence to medication schedule is important for healing of these ulcers and infections.
In advanced cases, following interventions needed : • Bandage contact lenses • Cynoacrylate glue therapy • Therapeutic corneal transplantation Will my vision recover completely after healing of ulcer? Vision recovery will depend on the severity of the infection. In some cases, vision recovery maybe suboptimal. However, if treated well, patients often regain good vision.
