Medically reviewed by Dr. Niranjana Bejan Singh. Written to established clinical-education standards (AAO/Mayo/NHS/NEI) and adapted for this hospital. Not a substitute for professional medical advice.
A corneal ulcer is an open sore on the cornea, most often caused by an infection, though injury and severe dry eye can also lead to one. It is a serious, sight-threatening condition that needs prompt diagnosis and treatment, since deep or untreated ulcers can cause permanent scarring and vision loss. Treatment is directed at the underlying cause and typically involves intensive antimicrobial eye drops along with close monitoring until the ulcer heals.
Who typically needs this
- Anyone with a painful, red eye and a visible white or grey spot on the cornea should be evaluated urgently, as this may indicate an ulcer.
- Contact lens wearers are at particular risk, especially with overnight wear, poor lens hygiene, or use of tap water with lenses.
- People with corneal injuries, such as scratches from fingernails, plant matter, or foreign bodies, are also at risk of developing an ulcer.
- People with severe dry eye, eyelid conditions preventing full blinking, or reduced corneal sensation face a higher risk.
What to expect
- Diagnosis involves a slit-lamp eye examination, often with a corneal scraping sent for laboratory culture to identify the causative organism.
- Intensive antibiotic, antiviral, antifungal, or anti-parasitic drops are started, often very frequently in the first days, based on the suspected or confirmed cause.
- Treatment is adjusted once culture results are available or if the ulcer is not responding as expected.
- In severe or non-healing cases, procedures such as corneal cross-linking, a therapeutic contact lens, or, in advanced disease, corneal transplant surgery may be needed.
Recovery
- Close follow-up, sometimes daily at first, is needed to confirm the ulcer is healing and not worsening.
- Pain, light sensitivity, and redness gradually improve as the infection is brought under control.
- Contact lens wear must be stopped during treatment and is usually avoided for some time afterward.
- Any residual corneal scarring can affect final vision, particularly if the ulcer involved the central cornea.
Risks to know about
- Delayed treatment can lead to permanent corneal scarring and reduced vision.
- Severe ulcers can progress to corneal thinning or, rarely, perforation, which is a medical emergency.
- Scarring in the central cornea may require a corneal transplant later to restore vision.
- Recurrence is possible, particularly with viral causes such as herpes simplex keratitis.
Frequently asked questions
Is a corneal ulcer an emergency?
Yes. A corneal ulcer needs prompt evaluation by an eye doctor, ideally the same day, because delayed treatment increases the risk of scarring and vision loss.
Can I keep wearing my contact lenses?
No. Contact lens wear should stop immediately if a corneal ulcer is suspected, and lenses should not be reused until the eye has fully healed and a doctor confirms it is safe.
Will my vision fully recover?
It depends on the size, depth, and location of the ulcer; ulcers away from the central cornea often heal with little effect on vision, while central or deep ulcers can leave lasting scarring.
How can I lower my risk?
Good contact lens hygiene, never sleeping in daily-wear lenses, avoiding tap water contact with lenses, and prompt attention to any eye injury or redness all help reduce risk.
Ready to see us?
Call the appointment desk, or book online — we will confirm your time by phone.
Sources consulted: AAO — What Is a Corneal Ulcer (Keratitis)?, Cleveland Clinic — Corneal Ulcer . General medical information — not a substitute for professional diagnosis. Medically reviewed by Dr. Niranjana Bejan Singh.
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