Any person may submit a corneal ulcer at any time in their lives. Depending on its degree (mild or severe) and the speed of treatment, it can be a one-off experience or something that compromises vision.
In addition to the depth and extent, the patient's age and the possible presence or absence of certain previous diseases also play a role in the prognosis. Today we are going to look at the causes of corneal ulcers in the eye, when it is necessary to see a specialist, what the possible complications are and how they are treated.
What is a corneal ulcer?
A corneal ulcer is an injury or wound to the cornea. The cornea is a transparent structure, located at the anterior pole of the eyeball, which allows light to enter from the outside, while protecting the iris and the crystalline lens.
There are mild corneal ulcers as well as severe or deep ones. Mild ulcers can be mistaken for a mild allergy or localised conjunctivitis, due to the sensation of a foreign body and the redness. However, in the event of any symptoms related to the sharpness of the visual field or following trauma to the eye, it is advisable to seek professional assessment immediately.
Often, a whitish or greyish spot or stain can be seen on the affected cornea, although it may be so small as to go unnoticed by the patient.
What is the origin of the eye ulcer?
Trauma
Many corneal ulcers are caused by mishandling when inserting or removing contact lenses and accidental trauma. Even an eyelash entering the eye can cause damage, especially if we instinctively rub the affected eye.
In other cases, previous inflammation predisposes the corneal membrane to be less resistant.
Common infections
There are corneal ulcers caused by herpes and also by fungal infections, although the most common in this group are those of bacterial origin.
Microscopic parasites
The Acanthamoeba is a micro-organism that can be present in swimming pools, showers or even tap water in some countries. When they infect the eyes, scarring is complicated to the extent that it can lead to permanent loss of vision in the affected eye.
The simple act of removing the contact lensesIf used when swimming, it considerably reduces the risk of infection by this micro-organism, as it does not allow it to be retained between the lens and the cornea for any length of time.
This same pathogen can be found in various soil ecosystems. If you accidentally get windblown solid particles in your eye, try to rinse it out with clean water as soon as possible.
Previous illnesses
Patients with diseases that affect healing processes and those whose immune system is depressed by disease or as a side effect of drug treatment (immunosuppressants or corticosteroids) are more likely to suffer from corneal ulcers and for them to progress more rapidly than in healthy patients.
Within the list of diseases, we cannot ignore diabetes and must include vitamin A deficiency.
Risks of corneal ulceration
Most corneal ulcers are easy to treat, especially if you go to a doctor or other medical practitioner. specialist ophthalmologist as soon as you start to notice the symptoms. However, we are talking about tissue that must heal and may or may not heal well, as with the skin. In some cases, a fibrous scar remains, causing vision problems in the affected eye.
When treatment of an eye ulcer is delayed or the patient does not follow the instructions of the antibiotic regimencomplications can occur, usually in the form of resistant or very extensive infections. In the worst cases, the cornea may progress from ulceration to perforation, with displacement of the iris or destruction of tissue in the ocular cavity.
If your corneal problem does not resolve within the expected timeframe, or if you are a patient who is a candidate for complications due to diseases such as diabetes, it is best to assess the possible seriousness of your case as soon as possible with a thorough and precise examination, such as the one we can perform at the Nebro Ophthalmology Clinic (ocular ultrasound, corneal topographyetc.).
What is your treatment?
Corneal ulcers can have different causes, although they share more than just the lesion itself: a bacterial, viral or fungal infection that may be there from the start or due to the proliferation of opportunistic micro-organisms that colonise damaged tissue.
Treatment will therefore seek to accelerate healing, if possible, while also combating these infections. This last point is vital when treating patients with compromised immune systems or those in whom the ulcer is a consequence of previous eye conditions.
When the ulcer has been caused by dry eyes or allergies, combined with erosion due to contact lenses, trauma or the accidental introduction of a foreign body (a windblown grit, for example), in addition to treating the eye ulcer, we will treat it to prevent the problem from recurring in the future.
A corneal ulcer requires immediate consultation with a physicianeven if the patient is not clear whether their symptoms are due to this injury. As a precaution, we also recommend consulting after any trauma that does not cause discomfort or photosensitivity.