Corneal Ulcer

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

Pain, photophobia, tearing, and reduced vision

Conjunctiva is injected

Discharge may be purulent or watery

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

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

Contact lens wearers with acute eye pain, redness, and decreased vision should be referred immediately