Corneal Ulcers

An ulcer can develop in the cornea (Fig 1) for many reasons. The most common is when contact lens patients sleep with their contacts or don’t wash their hands when putting a contact in their eye or when taking it out.

Figure 1

Figure 2

Bacterial

The most common cause of corneal ulcers is bacteria.

Treatment Options

Bacterial infections need to be treated with topical antibiotic drops and/or ointments (Fig 2). Sometimes injections need to be given on the surface of the eye. Oral antibiotics also may help.

Figure 3

Figure 4

Viral

The most common viral ulcer is cause by a herpetic virus (Fig 3). This is completely different from venereal herpes. We all have a herpes virus that lives near our brain and which can travel down a nerve and enter the eye.

Treatment Options

Treatment includes special anti-herpes drops or ointments. An oral anti-herpes medicine also may help.

Fungal

These ulcers are not common in our area. They can occur after a tree branch or other vegetative product injury to the eye (Fig 4).

Parasites

These types of ulcers are most often seen in contact lens wearers who swim with their contacts or put tap water in their eyes. The Acanthamoeba is the most common parasite causing corneal ulcers.