A corneal ulcer is a bacterial infection which damages the front of the eye, the cornea. A corneal ulcer is a very serious eye condition which can result in permanent vision loss or blindness if not treated appropriately and quickly.
What Causes a Corneal Ulcer?
A corneal ulcer will rarely occur without some form of damage to the cornea. Once the cornea is compromised, a bacterial, viral, or fungal infection can begin and result in an ulcer.
Among the most common causes of corneal ulcers are contact lens overwear, trauma which causes an abrasion on the eye, or a condition like a recurrent corneal erosion that repeatedly damages the cornea.
Any of these causes can lead to an ulcer by weakening the cornea and allowing bacteria or other pathogens to penetrate into the cornea which is normally not susceptible to infections.
Corneal Ulcers from Contact Lens Overwear
Contact lens wearers are at a much higher risk of developing a corneal ulcer simply because of the stress and damage that contact lenses place onto the cornea.
Specifically, overwearing contact lenses is a key risk factor for developing an infectious corneal ulcer.
If contact lenses are worn overnight or longer than the approved time frame, the cornea can become deprived of oxygen and weaken.
This weakened cornea is then more susceptible to damage from the contact lens or other things on or in the eyes and infection from bacteria.
Another risk factor with contact lenses is swimming, showering, or rinsing the contacts in tap water. The only thing that should come in contact with the lenses is the multipurpose cleaning solution which is approved to use with the contact lenses.
Tap water, swimming pool water, or lake water can contain a variety of bacteria which are particularly likely to infect the cornea and result in a corneal ulcer.
A contact lens wearer may have small amounts of damage on the front of the eye and allow these water native bacteria to cause an infection.
Corneal Ulcers from Trauma
Another major cause of corneal ulcers is a direct traumatic event to the eye. If the eye is scratched or cut with a foreign object like a rock, stick, or fingernail, the open wound can be a major site for developing a corneal ulcer.
Whenever the eye has already been damaged, there is a risk of infection both from a pathogen on the object that caused the damage (tree branch, etc) and from other pathogens in the environment which normally cannot penetrate a healthy cornea.
Corneal Ulcers from Recurrent Corneal Damage
Like direct trauma or abrasions, recurrent corneal damage can weaken the cornea and leave it vulnerable to infection and an ulcer.
The most common condition which results in the repeated damage of the cornea is a recurrent corneal erosion.
In this and other similar conditions, the cornea cannot ever fully heal and will be repeatedly damaged with blinks and other eye movements.
This damage and weakening of the cornea can allow pathogens to penetrate and infect the cornea.
How a Ulcer is Treated
A corneal ulcer will require prompt, aggressive treatment to try to prevent the permanent loss of vision in the eye.
Typically, at least one antibiotic eye drop will be used and other methods of increasing the healing process such as a bandage contact lens or amniotic tissue lens will be used.
After the infection is gone, steroid drops will be used to increase healing and decrease scarring.
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