How to treat corneal ulcers, and do they heal by themselves?

Doctor's Answers (2)

Corneal ulcers are a general term that refers to an inflammatory condition of the cornea that is characterised by a defect in the overlying corneal epithelium associated with immune white cell infiltration. 

The most common causes are that of infections (typically bacterial, viral, fungal or protozoal) and the treatments are specific to the causative organisms. Treatment is usually intensive initially then taper off as the infection is brought under control. Treatment duration may be prolonged in cases of viral, fungal or protozoal infections. Rarely are surgical procedures including debridement or corneal transplantations required.

Non-infective causes of corneal ulcers are treated with immune suppression including topical steroids and steroid-sparing agents. Rarely, severe inflammatory conditions may require systemic immunosuppression, anti-infective treatments and even surgical procedures of segmental corneal transplantation, conjunctival recession surgeries to assist with treatments. 

As you can tell - corneal ulcers almost always universally require treatment. The extremely rare mild corneal ulcer may resolve themselves however these are infrequent.

Most commonly, another similar condition called a corneal erosion may be mistaken for a corneal ulcer.

This condition causes recurrent eye discomfort, redness and pain / irritation that requires frequent use of eye lubricants to assist the cornea epithelium with healing. This is a condition that may go for long periods of time without active intervention / treatment, but often times if it becomes recurrent, may require the assistance of your ophthalmologist to assist the cornea with re-epithelialisation.

ESG

A corneal ulcer, by definition, is an area of inflamed cornea where the surface layer of cells (epithelium) has broken down to leave a 'raw' surface. As such, there are many kinds of and causes of corneal ulcers.

One of the most common kinds of corneal ulcers are those that are related to an infection associated with contact lens wear.

These kinds of ulcers require intensive antibiotic eyedrop use, usually starting off with one drop every hour of the day. That sometimes can mean 24 drops a day, ie eyedrops day and night around the clock, if it is severe enough. The patient also has to stop wearing contact lenses.

However, just to re-iterate, there is no one way to treat corneal ulcers because there are different kinds of corneal ulcers. If you have a corneal ulcer or you think you may have a corneal ulcer, the best thing is to see an eye doctor straight away.