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Dr. Andrew Rynne
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Article Home Eye Problems Corneal ulcer or Ulcerative keratitis

Corneal ulcer or Ulcerative keratitis

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Corneal ulcer is an inflammatory or infective condition of the cornea which affects epithelial layer with involvement of corneal stroma. Vitamin A deficiency is one of the causes of corneal ulcer.s


Corneal ulcer is an open sore on the cornea. In corneal ulcers there will be local necrosis of corneal tissue due to invasion of bacteria, fungi, viruses.

Causes of corneal ulcers

  • Bacterial infections cause corneal ulcers and is common in persons who wear contact lenses
  • Viral infection like herpes, varicella, chicken pox and shingles causes corneal ulcer
  • Fungal infections can lead to corneal ulcers. Fungal infections can occur due to excess use of eye drops which contain steroids
  • Trauma to eye
  • Chemical burns of eyes
  • Severe dry eyes
  • Foreign bodies in the eye
  • Severe allergic eye disease
  • Person’s who wear contact lens
  • Vitamin A deficiency

Signs and symptoms of corneal ulcers

  • Watering of eyes
  • Pain in the eyes
  • Squinting
  • Vision loss
  • Pus or thick discharge from eyes
  • Swelling of eyelids
  • Redness of eye
  • Blurring of vision
  • Pain while seeing bright lights.
  • Small pupil
  • Burning sensation in eyes
  • Itching of eyes
  • Aqueous flare (protein in the aqueous humour)
  • White or gray spot on the cornea.


  • Slit lamp examaintion
  • Fluorescein staining
  • Corneal scraping and examination of scrapings under microscope
  • Schirmer’s test
  • Microbiological culture tests of corneal scrapings
  • Keratometry
  • Visual acuity
  • Tear test
  • Pupillary reflex response


  • Antibiotic therapy to treat infection
  • Fungal corneal ulcers require anti-fungal agents
  • Topical cyclopegics like atropine or homatropine to dilate the pupil and to stop the spasms of ciliary muscle.
  • Deep corneal ulcers require conjunctival grafts or conjunctival flaps, soft contact lens or corneal transplantation
  • Topical corticosteroid drops
  • Pain medications like acetaminophen and ibuprofen can be taken

Prevention of corneal ulcers

  • Apply cool compresses to the affected eyes
  • Remove the contact lens if you are wearing
  • Avoid rubbing of eyes
  • Wash hands frequently
  • Avoid wearing contact lens overnight