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Eye Care

Treatment options for corneal ulcers

Keratitis or corneal ulcer is an open sore on the surface of cornea, which is the thin layer covering the iris. Cornea is responsible for the bending of light rays so they meet on the retina to form a perfect image. Corneal involvement, therefore, in any disorder can impact greatly on vision. However, with timely treatment the impact on vision is minimal and there are no long-term side effects. Corneal ulcers are very common in contact lens-wearers and in case of any pain in the eye, such individuals should rush to an ophthalmologist or Best Eye specialist in Lahore

What does a corneal ulcer look like?

Cornea is transparent and clear, but a corneal ulcer appears white/gray and opaque. Corneal ulcers can be too small, which is why they can’t be seen with naked eye and need special magnification and illumination. Hence, only a trained healthcare professional can make the diagnosis.

What are the symptoms of corneal ulcers?

Corneal ulcer is a severely painful condition that is often accompanied by redness, watering and a feeling of grittiness in the eye. The patient frequently complains of blurred vision and photophobia. Occasionally, there is pus-like thick discharge from the eyes. 

How is a corneal ulcer diagnosed?

Corneal ulcer is diagnosed on slit lamp—a special microscope—by a trained ophthalmologist. A drop of a dye is used on the eye, and then the eye is viewed in a slit lamp. The doctor may also take a sample of the ulcer for analysis of the microorganism involved, and the antibiotics it is susceptible to.

How are corneal ulcers treated?

The mainstay of therapy is antimicrobial agents, with pain management. Most corneal ulcers occur secondary to bacterial, viral or fungal infections, which is why the doctor will prescribe eye drops to kill these microbes. For several days, you will need to put the drops in the eye at least once an hour. Using antimicrobials will sterilize the ulcer, however, further treatment is needed to control the inflammatory response. 

Once the antibiotic starts working, a corticosteroid is added to decrease the inflammatory response and to reduce the odds of corneal scarring. This step is added with careful consideration as corticosteroids without antibiotic coverage can likely exacerbate the ulceration. 

Pain is managed with oral painkillers and eyedrops. Pupillary dilators may also be prescribed to reduce the discomfort. 

Surgery for corneal transplant is the last resort for a non-healing ulcer. Corneal ulcers are notoriously resistant to treatment and may end up needing a transplant as vision is severely compromised in corneal ulcer. 

The follow-up duration for corneal ulcer is somewhat lengthy. The doctor will need to see you almost every day to check the progress of the ulceration and the effect of the medication on healing.  

At-home care of corneal ulcer includes putting cold compresses on the eyes but be careful about keeping water away from the eyes. Constant handwashing is a must, to limit the spread of infection. Be sure to not rub the eyes with the fingers as rubbing can worsen the pain and the ulceration. If your ophthalmologist or Best Eye specialist in Islamabad permits, use over-the-counter pain medication like ibuprofen or acetaminophen for discomfort. 

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