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For further information, see CMDT Part 7-08: Corneal Ulcer
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Most commonly due to infection by bacteria, viruses, fungi, or amoebas (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
Inflammatory disorders that may be purely ocular or part of a systemic vasculitis
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Pain, photophobia, tearing, and reduced vision
Conjunctiva is injected
Discharge may be purulent or watery
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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
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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