Ophthalmology

Corneal ulcer

definition

A corneal ulcer is a superficial lesion, i.e. an injury to the cornea in the eye. Because the cornea is the foremost layer of the eye, it can e.g. B. be injured quickly by splinters. The injury remains limited to the top layers and is very painful.

Corneal ulcer symptoms

In the case of damage to the cornea, very pronounced symptoms. Since the cornea has a large number of nerve endings and is therefore well supplied by nerves, a corneal ulcer usually causes severe pain.

It can also lead to increased tearing. The increased tears of the eye serve as a protective and cleaning mechanism in the event of damage to the cornea, as occurs in a corneal ulcer.
However, the opposite is also possible: If there is not enough tear fluid, the eye becomes dry and a foreign body sensation can arise. A foreign body sensation, as if you had a grain of sand in your eye, is also common with corneal ulcers.

In some cases, pus is also secreted because the corneal ulcer is an inflammatory process. This also explains the clear reddening of the eye that usually occurs.

A corneal ulcer leads to permanent irritation of the eye. Therefore, those affected are often very sensitive to light. Furthermore, the irritation can lead to cramping of the eyelids.

Since the cornea plays an important role in vision, a corneal ulcer usually also leads to a significant impairment of vision. The environment can no longer be recognized so clearly and in the area of the corneal ulcer, as a rule, nothing can be seen anymore, since no light can enter the eye at this point.

Read more on the topic: Eye pain

What are the causes of a corneal ulcer?

The simplest example of this could be an injury caused by an object. Often these are objects such as Champagne corks, coat hangers or metal splinters.

However, a corneal ulcer can also be caused by blinking the eye too infrequently. This rare blinking of the eye manifests itself in the well-known "dry eye". As soon as the cornea is no longer adequately moistened with tear fluid, it dries out.
Various causes are conceivable: paralysis of the facial nerves, Parkinson's disease or a reduced blinking reflex.

But foreign bodies that are in direct contact with the cornea can also lead to a corneal ulcer. Wearing contact lenses for too long, for example, irritates the cornea and can dry out.

Also read: Foreign matter in the eye

How is a corneal ulcer treated?

The treatment of the corneal ulcer consists in extreme care of the cornea. Regular application of drops and especially ointments is in the foreground here. The ointments, which usually contain the active ingredient dexpanthenol, promote the regeneration of the cornea, so they help it to heal faster.

Despite the pain, the doctor - usually a specialist in ophthalmology - does not prescribe anesthetic eye drops or ointments, as these in turn reduce the blinking of the eye. If the patient no longer feels pain, there is also the risk that the eyes will be rubbed. A worsening of the initial situation is to be expected.

In severe cases of an ulcer that does not want to heal and the usual therapy fails, the still controversial autologous serum eye drops are used. These help many patients extremely well. These are eye drops that are obtained from the patient's blood. Many substances that are required for healing are extracted from the blood of the affected patient and enriched in the autologous serum eye drops.

You can find more about this belowr: autologous serum eye drops

How do you prevent a corneal ulcer?

A corneal ulcer can be prevented by keeping the eyes well hydrated. If you suffer from dry eyes, you should blink more.
Tear substitutes are also used here. If the cornea remains moist, the ulcer does not get a foundation. Tear substitutes are available in the form of drops, but corneal ointments can also be used.
These serve both for the prophylaxis of the corneal ulcer and for the healing of the ulcer that has already formed.

Otherwise, the best prophylaxis for eye injuries of all kinds is to wear protective goggles when doing manual work. This prevents splinters from penetrating the eye and damaging the cornea.

For contact lens wearers, correct handling is an important step in preventing possible corneal inflammation or a corneal ulcer.

Learn more at: Proper contact lens care

What is the prognosis for a corneal ulcer?

As a rule, corneal ulcers grow back quickly and are therefore no longer painful. The affected person should be symptom-free again within about 24 hours, of course depending on the size of the ulcer. If the injury was severe or went into deeper layers of the cornea, scars could remain. If these are in the optical axis, visual impairments may arise.

Occasionally, these injuries will heal more slowly or less well. In any case, an ophthalmologist (specialist in ophthalmology) should be consulted if the eye is injured.

Duration of a corneal ulcer

The duration of a corneal ulcer depends on the cause that led to the change in the cornea.

In the case of acute damage to the cornea, for example in the context of an infection, the duration of rapid, targeted therapy is relatively short. This is because targeted drug treatment against the underlying pathogen quickly leads to a cure.

However, if this infection is not recognized in time and a spreading corneal ulcer forms, it can take several weeks to months.

What is the healing process of a corneal ulcer?

The healing process of the corneal ulcer is significantly influenced by the time of diagnosis and the complications that may arise. If therapy is started soon, the chances of recovery and the associated regeneration of the cornea are very high.

In the case of advanced ulcers, however, perforation, i.e. a piercing of the cornea with tears, can occur. In such a case, a corneal transplant may have to be performed, but it usually heals quite well.

Find out more at: Eye surgery

Can a corneal ulcer develop from contact lenses?

In some cases, improper contact lens handling or improper contact lens care can also be the cause of a corneal ulcer. Insufficient cleaning of the contact lenses makes it easier for germs to penetrate and the infection can lead to a corneal ulcer.

In addition, contact lenses change the flow of tears in the eye, which can lead to the development of a corneal ulcer. It is therefore important to follow the instructions in the package insert and the ophthalmologist for correct use of the contact lenses. An ophthalmologist should be contacted in the event of pain or other complaints.

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