Corneal Ulcer
Ulceration of the cornea typically presents with a red, painful eye, with mild to severe discharge and reduced vision. The condition represents a localized infection of the cornea similar to an abscess. Most cases are due to a bacterial infection, commonly associated with antecedent trauma, especially contact lens wear . Other causative agents include fungi, acanthamoeba (a parasite), which typically occurs in contact-lens wearers who swim with the lenses in, or herpes simplex virus infection.
Bacterial Corneal Ulcer
Patients suspected of having a bacterial corneal ulceration are usually treated with frequent application of topical antibiotics , with or without initial cultures. The location and size of the ulceration will guide the ophthalmologist regarding the necessity of cultures.
Most patients are followed every one to three days depending on the severity of the condition. If the ulceration is in the central cornea, resolution of the condition is typically slower and vision may be permanently reduced due to scarring, despite early presentation and treatment.
Fungal Corneal Ulcer
Fungal keratitis (ulceration) may be suspected after trauma with vegetable matter such as a tree branch. In most cases, the eye is already compromised by pre-existing conditions. The diagnosis of fungal keratitis can only be made with microscopic evaluation of specially stained specimens or cultures. Anti-fungal agents are administered, sometimes both topically to the eye and orally, depending on the severity of the ulceration. The prognosis for good vision depends on the extent of infection. Some cases will require corneal transplantation (penetrating keratoplasty) despite early presentation and proper management.
