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Corneal Ulcer: Symptoms, Causes & Urgent Treatment

A corneal ulcer is an open sore on the cornea, usually caused by infection. It presents with pain, redness, light sensitivity, discharge and blurred vision, and is an eye emergency…

Corneal Ulcer: Symptoms, Causes & Urgent Treatment — specialist eye care at Sentra Clinic & Hospital, Mumbai
Specialist eye care at Sentra Clinic & Hospital, Malad East, Mumbai.
Quick Answer

A corneal ulcer is an open sore on the cornea, usually caused by infection. It presents with pain, redness, light sensitivity, discharge and blurred vision, and is an eye emergency — especially in contact lens wearers. Treatment must target the specific cause identified by examination and laboratory testing; never self-treat with leftover drops.

Eye emergencyA painful red eye with reduced vision or significant light sensitivity needs prompt professional eye evaluation. A corneal ulcer can progress within hours to days, and delay risks permanent scarring or worse.
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What is a corneal ulcer?

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A corneal ulcer is a break in the corneal surface with underlying tissue loss and inflammation, most often due to infection. It typically appears as a white or greyish spot on the cornea and is accompanied by significant discomfort.

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Symptoms

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  • Severe eye pain and a gritty foreign-body sensation
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  • Redness, watering and pus-like discharge
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  • Marked light sensitivity and difficulty opening the eye
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  • Blurred or reduced vision
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  • A visible white spot on the cornea
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Causes and risk factors

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  • Contact lens wear — especially overnight wear, poor hygiene or rinsing lenses in tap water; the single most important modifiable risk
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  • Bacterial infection — the most common cause in lens wearers
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  • Viral infection — herpes simplex and herpes zoster keratitis
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  • Fungal infection — classically after vegetative trauma
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  • Acanthamoeba — a water-associated organism affecting lens wearers; very painful and difficult to treat
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  • Other contributors — eye injury, severe dry eye, eyelid problems exposing the cornea, and inappropriate steroid drop use
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Why urgent examination matters

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Different organisms require entirely different, sometimes opposite, treatments. Steroid drops — or any leftover medication — used without diagnosis can catastrophically worsen an infection. Do not self-treat, and do not use old prescriptions.

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How it is diagnosed

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After slit-lamp examination, the doctor may take a corneal scraping for microscopy and culture to identify the organism. Treatment frequently begins the same day and is refined when laboratory results return.

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Treatment depends on the cause

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  • Intensive antimicrobial drops (bacterial, fungal or anti-amoebic as indicated), sometimes around the clock initially
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  • Cycloplegic drops for comfort; oral medication in selected cases
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  • Antiviral therapy for herpetic disease, with steroid use only under specialist supervision
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  • Hospitalisation, corneal gluing or therapeutic transplantation for severe, thinning or perforating ulcers
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Potential complications

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Even with successful treatment, ulcers can leave corneal scars; severe cases may thin, perforate, or require emergency grafting. Vision rehabilitation — lenses or transplantation — is considered once the eye is quiet. Contact lens wear should be stopped immediately and only resumed if your specialist approves.

Information on this page is for general education and does not replace an examination, diagnosis or personalised medical advice from a qualified eye-care professional.

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