Bacterial Keratitis / Corneal Ulcer

What's going on?

You have an infection of the cornea (the clear window at the front of
the eye). If untreated, an ulcer can result in significant loss of
vision due to spreading of the infection throughout the
cornea. Sometimes the infection even causes the cornea to perforate and
allow the fluid from inside the eye to leak out.

What will my ophthalmologist see?

The eye will be red. The cornea will have some degree of white
opacity. Fluorescein will show a green stained area (corresponding to
the ulcer).

What will my ophthalmologist do for me?

This is dependant upon the severity of the ulcer. We will sometimes
take a sample to be sent off to the lab in the hope of identifying the
bug causing it. If the ulcer is severe we often admit patients to give
them intensive antibiotic drops. Drops are usually given every hour
(including overnight!) and then tapered off according to how you
respond. If the ulcer is not so bad we can treat it with drops as an
outpatient. Frequent follow-up will be required.

What do I need to do?

You need to make sure it doesn't happen again! (See below)

What do I need to know?

The most important risk factor is wearing contact lenses. Some of you
are unfortunate enough to develop the ulcer spontaneously even though
you don't wear contact lenses. If you develop the ulcer and you are a
contact lens wearer then it is all your fault! Poor hygiene is usually
the problem. Wearing your lenses over night is a common culprit.

Your lenses, cases and cleaning solutions should all be discarded as
any one of them may harbour bugs. Any ulcer leaves a scar when it heals,
but if it is on the edges of the cornea you may not experience any
problem with your sight. If you have another infection you may not be so
lucky. If the ulcer occurs on the part of the cornea you see through
you will lose vision permanently. You should not wear contact lenses
until the infection has been completely clear for at least a month (some
ophthalmologists recommend stopping contact lens wear altogether after a
proven infection).