Corneal Ulcer
Most corneal ulcers are caused by infections.
Bacterial infections cause corneal ulcers and are common in people who wear contact lenses.
Viral infections are also possible causes of corneal ulcers. Such viruses include the: • herpes simplex virus that causes cold sores. Cold sores are small, painful, fluid-filled blisters or sores that appear on the lips, mouth, or nose that are caused by a virus. The sores can be painful and usually last a few days. Unlike most viral infections, the cold sore virus is not completely eliminated by the body defenses. For this reason, cold sores often recur.
Μore about ocular herpes here.
• the varicella virus (the virus that causes chickenpox and shingles).
Fungal infections can cause corneal ulcers and may develop with improper care of contact lenses or the overuse of eye drops that contain steroids.


Tiny tears to the corneal surface may become infected and lead to corneal ulcers. These tears can come from direct trauma by scratches or metallic or glass particles striking the cornea. Such injuries damage the corneal surface and make it easier for bacteria to invade and cause a corneal ulcer.
Μore about cornea here.

Disorders that cause dry eyes can leave your eye without the germ-fighting protection of tears and cause ulcers.

Disorders that affect the eyelid and prevent your eye from closing completely, such as Bell's palsy, can dry your cornea and make it more vulnerable to ulcers.

Any condition which causes loss of sensation of the corneal surface may increase the risk of corneal ulceration.

Chemical burns or other caustic (damaging) solution splashes can injure the cornea and lead to corneal ulceration.

People who wear contact lenses are at an increased risk of corneal ulcers. The risk of corneal ulcerations increases tenfold when using extended-wear soft contact lenses. Extended-wear contact lenses refer to those contact lenses that are worn for several days without removing them at night. Contact lenses may damage your cornea in many ways:
  • Scratches on the edge of your contact lens can scrape the cornea's surface and make it more vulnerable to bacterial infections.
  • Similarly, tiny particles of dirt trapped underneath the contact lens can scratch the cornea.
  • Bacteria may be on the improperly cleaned lens and get trapped on the undersurface of the lens. If your lenses are left in your eyes for long periods of time, these bacteria can multiply and cause damage to the cornea.
  • Wearing lenses for extended periods of time can also block oxygen to the cornea, making it more susceptible to infections.


  • Red eye
  • Pain in the eye
  • Feeling that something is in your eye
  • Tearing
  • Pus or thick discharge draining from your eye
  • Blurry vision
  • Pain when looking at bright lights
  • Swollen eyelids
  • A white or gray round spot on the cornea that is visible with the naked eye if the ulcer is large

Exams and Tests
Because corneal ulcers are a serious problem, you should see your ophthalmologist (a medical doctor who specializes in eye care and surgery).
Your ophthalmologist will be able to detect if you have an ulcer by using a special eye microscope, known as a slit lamp.
If your ophthalmologist thinks that an infection is responsible for the ulcer, he or she may then get samples of the ulcer to send to the laboratory for identification.

Corneal Ulcer Treatment

Self-Care at Home
If you wear contact lenses, remove them immediately.
Apply cool compresses to the affected eye.
Do not touch or rub your eye with your fingers.
Limit spread of infection by washing your hands often and drying them with a clean towel.
Take over-the-counter pain medications, such as acetaminophen (Tylenol) or ibuprofen (Motrin).

Medical Treatment
Your ophthalmologist will remove your contact lenses if you are wearing them.
Your ophthalmologist will generally not place a patch over your eye if he or she suspects that you have a bacterial infection. Patching creates a warm dark environment that allows bacterial growth.
Hospitalization may be required if the ulcer is severe.

Because infection is a common occurrence in corneal ulcers, your ophthalmologist will prescribe antibiotic eyedrops. If the infection appears very large, you may need to use these drops as often as one drop an hour.
Oral pain medications will be prescribed to control the pain. Pain can also be controlled with special eyedrops that keep your pupil dilated.

Next Steps
If you do not need hospitalization, you will need to follow up with your ophthalmologist daily until your ophthalmologist tells you differently.
You should contact your ophthalmologist immediately if you experience symptoms such as worsening vision, pain, discharge, or fever.


Seek medical attention from your ophthalmologist immediately for any eye symptoms. Even seemingly minor injuries to your cornea can lead to an ulcer and have devastating consequences.
Wear eye protection when exposed to small particles that can enter your eye.
If you have dry eyes or if your eyelids do not close completely, use artificial teardrops to keep your eyes lubricated.
If you wear contact lenses, be extremely careful about the way you clean and wear your lenses.
  • Always wash your hands before handling the lenses.
  • Never use saliva to lubricate your lenses because your mouth contains bacteria that can harm your cornea.
  • Remove your lenses from your eyes every evening and carefully clean them.
  • Never use tap water to clean the lenses.
  • Never sleep with your contact lenses in your eyes.
  • Store the lenses in disinfecting solutions overnight.
  • Remove your lenses whenever your eyes are irritated and leave them out until your eyes feel better.
  • Regularly clean your contact lens case.