Corneal ulcers are open sores on the cornea that are most often caused by infection. This condition, also known as keratitis, is a medical emergency. If not treated immediately, corneal ulcers can lead to blindness.
The cornea is a clear membrane located in front of the eye. This organ has many functions, one of which is to refract light that enters the eye. In other words, the cornea largely determines a person's ability to see clearly.
Corneal ulcers can interfere with the entry of light into the eye so that it interferes with vision. In addition, the cornea also serves to protect the eye from dirt or germs. When the cornea is damaged, the eye is more susceptible to infections that can damage the eye.
Corneal Ulcer Causes
Corneal ulcers are most often caused by viral, bacterial, fungal, or parasitic infections. Here is the explanation:
1. Viral infection
Corneal ulcers can be caused by infection with the herpes simplex virus (HSV) in the eye. Infections caused by this virus can recur from time to time. Relapses can be triggered by stress, weakened immune systems, or prolonged exposure to sunlight.
Apart from herpes simplex, corneal ulcers can also be caused by viral infections Varicella. Viral infection can occur through direct contact with someone infected with the varicella virus or HSV. However, usually the virus attacks other parts of the body first before the eyes.
2. Bacterial infection
Corneal ulcers caused by bacterial infections usually occur as a result of wearing contact lenses for a long time. This condition makes the cornea not getting enough oxygen so it is susceptible to infection.
Bacteria can grow on contact lenses that are scratched or not properly cared for. In addition, bacteria can also grow in contact lens cleaning fluid. These bacteria can grow and trigger ulcers, especially if contaminated contact lenses were worn for a long time.
3. Fungal infection
Corneal ulcers caused by fungal infections are rare. Fungal infections of the cornea generally occur when the eye is exposed to organic material, such as plant branches or objects made of plants.
In addition, corneal ulcers due to fungal infections can occur as a result of excessive or long-term use of steroid eye drops.
4. Parasitic infection
Corneal ulcers due to parasitic infections are most often caused by: Acanthamoeba, which is a type of amoeba that lives in water and soil. Infection can occur if a person wears contact lenses that are dirty and contaminated with this parasite.
In addition, doing activities in water that is likely to be contaminated, such as lake water or river water, can also increase the risk of infection with this parasite.
Apart from infection, corneal ulcers can also be caused by the following conditions:
- Dry eye syndrome
- Ingrown eyelashes (entropion)
- Eyelids are folded out
- Inflammation of the eyelids (blepharitis)
- Chemical exposure to the eye
- Vitamin A deficiency
- Injury to the cornea due to exposure to something, such as sand, broken glass, makeup tools, or nail clippings when cutting nails
- Disorders that affect the function of the eyelids, such as Bell's palsy which causes the eyelids to not close and makes the cornea dry, thus triggering the formation of ulcers.
Corneal Ulcer Symptoms
Symptoms of a corneal ulcer include:
- Watery eyes
- Eyes sensitive to light (photophobia)
- Red eye
- Itching or pain in the eyes
- White spots on the cornea
- Blurred vision
- Feels like something is stuck in the eye
- Swollen eyelids
- Eyes oozing pus
When to go to the doctor
Immediately consult an ophthalmologist if you experience the above complaints, especially if you use contact lenses or if before the symptoms appeared you had an eye injury.
It is important to remember that all symptoms of a corneal ulcer should be examined immediately. Corneal ulcers are conditions that must be treated quickly. If left untreated, corneal ulcers can cause permanent damage to the eye and even blindness.
Corneal Ulcer Diagnosis
To diagnose a corneal ulcer, an ophthalmologist will use a special microscope for the eye or slit lamp. To make the ulcer more visible, the doctor will give special eye drops (fluorescent) to the patient's eye. This eye medication can make the damaged part of the cornea glow.
If the doctor suspects that a patient's corneal ulcer is caused by an infection, the doctor will take a sample of the cornea for culture and study in the laboratory. By knowing the type of microorganism causing the infection, appropriate treatment can be given.
Corneal Ulcer Treatment
Treatment for corneal ulcers depends on the cause and the patient's condition. Methods that can be done by doctors include:
Drugs
Your doctor may prescribe antiviral, antibiotic, or antifungal medications, depending on the cause of the corneal ulcer itself. The drugs given can be in the form of drops, ointments, or injections around the eyes. In corneal ulcers of unknown cause, the doctor will give antibiotic eye drops that can kill many types of bacteria.
Other drugs that can be given by doctors are special eye drops to dilate the pupils. This medication can relieve pain, but it can also cause blurred vision. In addition to pupil dilation drugs, doctors can also give you oral medication to relieve pain.
Corticosteroid eye drops may be given after treatment for the infection is complete. The purpose of administration is to relieve swelling and inflammation. However, the use of this drug must be closely monitored by an ophthalmologist, because if it is excessive it can cause dangerous side effects.
Surgical procedure
In the case of a very severe corneal ulcer, the doctor will suggest a keratoplasty or a corneal transplant. Keratoplasty is performed by replacing the patient's damaged cornea with a healthy cornea from a donor.
Self therapy
To help with treatment, the doctor will advise the patient to do the following:
- Give cold compresses to the eyes, but don't let the eyes get water
- Taking pain relievers, such as paracetamol or ibuprofen
- Limiting the spread of infection by regularly washing hands and drying them with clean towels
- Don't touch or rub your eyes with your fingers
- Don't wear contact lenses and eye makeup
Corneal Ulcer Prevention
Corneal ulcers can be prevented by seeking medical attention immediately if symptoms of an eye infection appear, or if an eye injury occurs. In addition, take the following precautions:
- Wear protective eyewear when doing activities that pose a risk of injuring the eyes or causing squints
- Using artificial tears to keep the surface of the eyeball wet if you have dry eye syndrome or your eyelids don't close properly
Because corneal ulcers commonly occur in contact lens wearers, use and care for contact lenses according to the instructions for use. In addition, also do the following things:
- Wash your hands and make sure your hands are dry before touching the lenses
- Do not use tap water to clean contact lenses
- Do not use saliva to clean the lens, because saliva contains bacteria that can injure the cornea
- Take off contact lenses before going to bed
- Take off contact lenses if eye irritation occurs and don't wear them before the eye heals
- Clean contact lenses before and after use
- Change contact lenses according to the time recommended by the doctor