Corneal Abrasions and Ulcers

Monday, Nov 1, 2021 by Nisha Gupta, MD

Continuing our discussion on various causes of red eye, this month we will discuss corneal abrasions and ulcers.

What are corneal abrasions and ulcers and their symptoms?

A corneal abrasion is a scratch on the surface of the eye and an ulcer is a deeper defect in the cornea.

Both can cause a red eye and pain. The vision can be affected. Other symptoms include a sensation of something in the eye, light sensitivity, and tearing. With an ulcer, one may see a white spot on the eye surface.

What are some of the causes?

Abrasions are usually caused by a foreign object getting into the eye, such as a dust particle, metal, wood, or sand. Rough removal of contact lenses or even the edge of a piece of paper can cause an abrasion.

Ulcers are caused by various infections including bacterial, viral, fungal, and parasitic. Trauma or injury like an abrasion can allow for an infection and subsequent ulcer to occur. Conditions that prevent the eye from closing can dry the surface and cause an ulcer, and there are several inflammatory diseases that may result in ulcer formation.

How are these diagnosed?

These are diagnosed with an eye exam. Doctors will use fluorescein eye drops to see the extent of the abrasion or ulcer. In some cases of an ulcer, a small tissue sample needs to be taken to determine what is causing the infection.

What are the treatments?

The most important thing is to try and prevent these from happening. People who wear contact lenses are at very high risk for developing ulcers. It is important not to wear lenses for long periods of time or overnight. Use clean hands to place and remove the lenses and do not make or reuse contact solution.

Most cases of abrasions heal quickly. Often doctors will prescribe an antibiotic drop or ointment to prevent infection.

Ulcers may take longer to heal depending on the severity. Eye drops are usually prescribed depending on the cause (for example antibiotics for a bacterial infection). Oral medications may also be prescribed. Occasionally steroid eye drops are given if there is inflammation. Severe ulcers that do not heal may require a corneal transplant.

It is advised not to wear contact lenses or use makeup while on treatment for these conditions.

If you have had or think you had an injury to the eye, make sure to see an eye specialist as soon as possible.

Return next month for a discussion on a new topic!

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