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

Doctor's Answer

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

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