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Corneal Ulcer
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Cornea is an important part of the an eye. An ulcer formed on it is known as a Corneal Ulcer. The term infiltrate is also commonly used along wit ulcer. An infiltrate is defined as an immune response which causes deposition or collection of cells or fluid in on area of the body where they don’t normally belong. The ulcers formed in the cornea may be infectious or may not be associated with an infecting organisms that is it may be sterile.

The infected ulcers also known as bacterial ulcers tend to be extremely painful. They are commonly associated with a break in the epithelium, that is the superficial layer of the cornea. In certain cases, the inflammatory response involves the anterior chamber of the eye also along with the cornea. Certain types of bacteria, such as Pseudomonas, are extremely aggressive and can cause severe damage and even blindness within 24-48 hours if left untreated.

Sterile infiltrates, does not causes any pain. But rarely, if it occurs, it is very little. The sterile infiltrates are commonly found near the peripheral edge of the cornea. It has been observed that they are not always associated with a break in the epithelia layer of the cornea.

Causes of Corneal Ulcer

There are several causes of the corneal ulcers. Contact lens wearers, especially soft ones have in increased risk of ulcers particularly if they do not adhere to strict regimens for the cleaning, handling and disinfect -ion of their lenses are designed to have very high water content and can easily absorb bacteria and infecting organisms if not cared for properly. Bacterial ulcers may be associated with diseases that compromise the corneal surface, thus creating a window of opportunity for organisms to infect the cornea.

Patients who have severally dry eyes, difficulty blinking or are unable to care for themselves are at high risk for developing Corneal Ulcer. Other causes of ulcers are the herpes simplex viral infections, inflammatory diseases, corneal abrasions or injuries and other systemic diseases. Pseudomonas is common cause of corneal ulcer seen in those who wear contact lenses.

Signs and symptoms of Corneal Ulcer

The symptoms which are associated with Corneal Ulcers depend upon whether the ulcers is infectious or sterile. It also depends upon the aggressiveness of the infecting organism. The most common symptoms of the corneal ulcers is Red coloured eye. There may be severe pain felt. It is noted particularly in infectious cases. There may be tearing noted. There may be also discharge observed from the eye. There may be white spot on the cornea. These spots depends upon the severity of the ulcer. These white spots may not be visible with the naked eye.

Diagnosis of Corneal Ulcer

The corneal ulcers are diagnosed with a careful examination using a slit lamp microscope. Special types of eye drops containing dye such as fluoresce in may be used to highlight the ulcer, thus making it easier to detect.

If an infectious organism is suspected them culture is done. For this the eye is numbed with topical eye drops, then the cells also gently scraped from the corneal surface and finally tested to determine the infecting organism.

Treatment of Corneal Ulcer

The treatment for corneal ulcer depends upon whether the ulcer is sterile or infectious. Bacterial ulcer require aggressive treatment. In certain cases, the antibacterial eye drops are used every 15 minutes. Steroid medications are avoided in cases of infectious ulcers.

Some patients with severe ulcers may require hospitalization for intravenous antibiotics and around the clock therapy. Sterile ulcers are mainly treated by reducing the eye’s inflammatory response with steroid drops, antibiotics, etc.



 

 

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