When the word ulcer is mentioned, you'd probably think that it refers to the type that's found in our mouths. However, did you know that there are other types of ulcers you should be wary of?
A corneal ulcer is an erosion or an open sore on the surface of the cornea. A Human reader wanted to find out if corneal ulcers heal by themselves, and the best course of treatment for this condition.
Dr E-Shawn Goh, an experienced ophthalmologist shares his professional advice.
What are corneal ulcers?
A close up of the corneal ulcer during an eye examination
A corneal ulcer refers to an inflammatory condition of the cornea. It develops when there is a break in the corneal epithelium (a membranous tissue composed of one or more layers of cells).
Essentially, a corneal ulcer can be described as an open sore of the cornea.
It's caused primarily by infections
Corneal ulcers are most commonly caused by bacterial, viral, fungal or protozoal infections. Corneal ulcers can also be caused by other factors including physical and chemical trauma, corneal over-exposure.
Poor contact lens hygiene is one of the most common causes. [1]
Treatment usually starts off intensive
Treatment for corneal ulcers usually starts off more intensive because some ulcers can lead to vision loss and blindness. It tapers off once your infection is brought under control.
Your doctor might prescribe antibiotics as well as antiviral or antifungal medications. [2]
In cases of viral, fungal, or protozoal infections, the treatment duration may be longer.
On rare occasions, surgical procedures may be required
Surgical procedures including debridement (the surgical removal of the surface layer of cells) or corneal transplantations may be suggested by doctors in severe cases.
However, Dr E-Shawn emphasised that this rarely happens.
Immune suppression is used for non-infective causes of corneal ulcers
If your corneal ulcer did not stem from an infection, immune suppression treatment is usually carried out. This includes topical steroids and steroid-sparing agents.
Severe inflammation may require extra measures
In other rare cases that include severe inflammatory conditions, systemic immunosuppression may be required.
Your doctor may also implement anti-infective treatments and even surgical procedures that involve segmental corneal transplantation or conjunctival recession surgery alongside treatments for more effective outcomes.
Corneal ulcers almost never resolve themselves
According to Dr E-Shawn, corneal ulcers almost always require treatment. However, there are extremely rare cases where a mild corneal ulcer seen in a patient may resolve itself (but these are very infrequent).
Corneal ulcers are sometimes mistaken for corneal erosion
Corneal erosion is a similar condition that causes recurring eye discomfort, redness and pain or irritation. Generally, it requires the frequent application of eye lubricant that helps the corneal epithelium heal.
Often, corneal erosion may go long periods without active treatment but ophthalmologists might need to step in to assist the cornea with re-epithelialisation (when an open wound is covered by epithelial cells) if the condition becomes recurrent.
Always practice good eye hygiene
If left unchecked, corneal ulcers can become serious and might even result in loss of vision or blindness. Always practice good eye hygiene and go for regular checks.
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