Keratitis (Corneal Ulcers)

Reviewed by Christopher T. Hood, M.D.

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What Is Keratitis (Corneal Ulcers)?

Infectious keratitis and corneal ulcers refer to the invasion of an infectious organism, such as bacteria, into the cornea.  As a general rule, the deeper the corneal infection, the more severe the symptoms and complications. It should be noted that while relatively infrequent, a corneal ulcer is the most serious complication of contact lens wear.

Symptoms

  • Pain and eye irritation
  • Eye redness
  • Blurred vision
  • Light sensitivity
  • Discharge

The symptoms described above may not necessarily mean that you have keratitis. However, if you experience one or more of these symptoms, contact your ophthalmologist for a complete exam.

Causes

A corneal ulcer usually occurs after corneal trauma or with an irregular ocular surface, which allows bacteria, fungus, or parasites to enter the cornea and cause an infection with inflammation. 

Risk Factors

Trauma from a foreign body (including contact lenses), severe dry eyes, or eyelid disease can predispose patients to corneal infections.  Contact lens overuse or poor contact lens hygiene also puts a patient at higher risk for such infections due to the bacteria and other organisms that can grow on the contact lenses, cases, and in re-used contact lens solution.

Tests and Diagnosis

An eye care professional can diagnose a corneal infection during an eye exam.  More severe ulcers may be sampled and sent to a lab for cultures to identify the offending organism.  Occasionally, special imaging with a high-resolution microscope can be utilized to look for atypical organisms when infections do not respond to common treatments.

Treatment and Drugs

Minor corneal ulcers can usually be treated with anti-bacterial eye drops. If the problem is more severe, the patient may receive more intensive or specially formulated antibiotic drops to eliminate the infection. Occasionally, steroid eye drops are also used to reduce inflammation.  In the case of suspected fungal or parasitic infection, a patient may receive special antibiotics specifically targeted at these organisms.  After the infection is resolved, residual corneal scarring or thinning can occur, and occasionally corneal transplantation may be recommended to restore vision. Early treatment may help reduce the risk of complications. Frequent visits to an eye care professional may be necessary for several months to eliminate the problem.

Clinic Information

For more information, see the Cornea & External Disease, Cataract & Refractive Surgery Clinic and the complete Clinic Services listing of the U-M Kellogg Eye Center.

Last Modified: Wednesday, 19-Feb-2014 08:42:44 EST