Corneal Ulcer

Corneal Ulcer

What is Corneal Ulcer
Corneal Ulcer or Keratitis means an open sore or infection of the cornea (the front most layer of the eye). It may be caused by micro-organisms (germs) that are not visible to the naked eye e.g. bacteria, fungi, viruses, and parasites. Corneal infection causes pus collection in the corneal tissue, which leads to redness, watering, pain, decrease in vision and white sticky discharge.

Corneal infection causes pus collection in the corneal tissue, which leads to redness, watering and white sticky discharge.

What are the symptoms of Corneal Ulcer?
• Hazy vision
• Severe Pain and redness
• Feeling that there is foreign particle in the eye
• Increased pain when looking at bright light
• White sticky pus and thick discharge
• Whitish patch on the cornea

If detected late, corneal ulcer can cause full loss of eyesight in a short time. It can also raise the pressure of the eye (glaucoma).

Is Corneal Ulcer common problem?
Corneal Ulcer is common in the following conditions: contact lens users, dry eyes, abnormal eyelash growth, diabetics, immunosuppressed individuals, those on chronic steroid (local or systemic) use, cases with immunological diseases e.g. rheumatoid arthritis. It is also common following trauma or chemical burns of the eye. In rare occasions, infections may occur post eye surgeries and post facial nerve paralysis.

Among contact lens users, there is 10 times more risk of corneal ulcer if they use extended wear (overnight) soft contact lenses.

How can we diagnose corneal ulcer ?
Preliminary diagnosis is by clinical examination with a microscope (Slit lamp biomicroscopy). Investigations are done to further confirm corneal ulcer or to detect the micro-organism causing the ulcer to give a specific treatment. These investigations are:

  • Corneal Scrapings - sample from ulcer is sent to the lab to see bacterial or fungal infections through microbiological culture testing
  • Corneal Scan (Anterior Segment OCT scan)
  • Eye serial photographs
  • Confocal imaging
Blood tests are also done for corneal ulcer e.g. fasting blood sugar, hemogram, etc. Depending upon the size of the ulcer, it may be mild or moderate or severe.

What is the treatment for Corneal Ulcer?
Medications: The various drops used in medical management are:
• Antibiotic or antiviral or anti fungal drops
• Cycloplegic drops - drops to widen the pupil
• Antiglaucoma drops
• Corneal lubricants
• Painkillers

Surgery:If ulcer does not heal with only medications or is severe, the doctor may plan a corneal surgery.

What is the surgery for Corneal Ulcer?
Corneal transplantation is done in corneal ulcer on an emergency basis. In this surgery, the diseased cornea is cut and removed and replaced with healthy cornea obtained from the donor from the eye bank. The donor cornea is secured with 16 or more sutures in the eye. Post surgery, the medications will be required for about 6 months to 1 year, varying with each case.

What are the complications of corneal transplantation surgery ?
Corneal transplantation has a risk of complications, though less in incidence. Some patients may experience hazy vision (80-85%) or develop recurrence of corneal infection (5%) after corneal transplantation. Other complications can be: development of glaucoma, cataract and/or whitish patch on the cornea (a scar or opacity). Patients must understand the emergency corneal transplantation is to prevent further loss of vision, but the affected eyesight (due to effect of ulcer on the nerve giving eyesight) may not be regained after surgery. A second surgery may often be required if cataract or glaucoma develops.

What is the anaesthesia used for this surgery ?
Corneal transplantation is performed under a local anaesthesia, which means you will be awake throughout your operation and an injection around your eye will be used to make your eye numb. This injection will prevent you from feeling any pain during the operation. You will not be able to see details of what is happening, but you might be aware of the bright lights or movement in the operating theatre. During the operation, we will ask you to lie as flat as possible and keep your head still.

At the end of the operation, we usually put a pad and shield over your eye to protect it. These will be removed the morning after your surgery.

Some cases with corneal perforation may be operated in general anesthesia i.e. where you will be in non-awake state.

What is the home care advised for Corneal Ulcer?
  • Don’t touch your eyes with hands
  • Wash and dry hands before and after each drops you use in your eye.
  • Never use same vial of drops for the other healthy eye
  • Maintain self hygiene e.g. separate towel, frequent hand wash to protect your other eye and other family members.
  • Place cool compresses on the eye (dry only, no water to be used over the eye)
  • Refrain from using contact lenses till your doctor advises so.
Synergy Eye Care is well equipped and its doctors are well experienced in treating this disease using required procedures and /or surgeries with good results.


Disclaimer: Information published here is for educational purposes only and is not intended to replace medical advice. If you suspect that you have a health problem, please consult your doctor immediately

Expert Doctors

Dr. Surabhi Dutt

MBBS, MS

Cornea, Ocular Surface, Cataract and Refractive

Dr. Aditi Ghosh

MBBS, MS

Cornea, Cataract and Refractive