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Key Features

  • Most commonly due to infection by bacteria, viruses, fungi, or amebas (see Keratitis, Infectious)

  • Noninfectious causes include

    • Neurotrophic keratitis (resulting from loss of corneal sensation)

    • Exposure keratitis (due to inadequate eyelid closure)

    • Severe dry eye

    • Severe allergic eye disease

    • Various inflammatory disorders that may be purely ocular or part of a systemic vasculitis

Clinical Findings

  • Pain, photophobia, tearing, and reduced vision

  • The eye is red, with predominantly circumcorneal injection

  • Discharge may be purulent or watery

Diagnosis

  • The corneal appearance varies according to the underlying cause (see Keratitis, Infectious)

  • Some ulcers are most easily seen after instillation of fluorescein and examination with a blue light

Treatment

  • Delayed or ineffective treatment of corneal ulceration may lead to devastating consequences with corneal scarring or intraocular infection

  • Any patient with an acute painful red eye and corneal abnormality should be referred emergently to an ophthalmologist

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