Greetings to all and sundry,
It is a beautiful day today and a wonderful weeek so far and i am so excited to have this opportunity to come your way once again with another one of our ocular health discussions as we have been doing. Before we move on though, i do hope all is well with you?
It is always a pleasure getting the opportunity to share my knowledge with you my dear readers and i feel it a great way to impact patients across the globe thus making the work of Optometrists such as myself and the work of healthcare workers in general easier. For today we would be looking at a condition of the eye which is quite painful and sight-threatening when not done right.
Cornea is a transparent layer in front of the eye, it is through it that you see the darkness in the middle of the eye which is the inside of the eye or through the pupil and the colored part of the eye known as the iris.. It refracts light together with anterior chamber and lens accounting for approximately 2/3 of the eye’s total optical power. The cornea has a refractive power of about 40diopters thus does most of the work when it comes to getting light into the eye.
The cornea has five layers; the epithelium (the outer most layer), bowman’s layer, stroma (which forms about 90% of the corneal thickness), descement’s membrane and the endothelium (Which is the innermost layer). Cornea is made up of about 4.5% mucopolysaccharides.
The cornea is one of the most sensitive tissues in the entire body which makes it extremely painful when anything happens to it. Thus, our topic of discussion today is one of pain and lots of tearing for individuals who find themselves in this predicament.
Cornea ulcer is a condition in which there’s an inflammation of the outermost layer thus the epithelium of the eye which results in a lot of pain, in simple terms it may be considered as an open sore on the cornea. This can occur as a result of a direct injury to the eye or as a result of an infection on the eye which may be bacteria, fungal, viral or parasitic in nature.
Parasitic infections are extremely difficult to treat and has the worst outcome in most cases. Whether your cornea ulcer sterile or infectious your optometrist may give you some antibiotics to keep out infection from starting or spreading out on the eye. Corneal ulcers are delicate conditions which out to be treated with care and by a specialist.
There are certain medication that may interrupt the healing process and cause scars on the eye when used in these instances thus using over the counter drugs becomes a big No as the wrong medication could result in permanent blindness for the individual should the ulcer be located central to the cornea.
Cornea Ulcer may present with symptoms such as redness of the eye which is as a result of the inflammation going on, the pain felt may also cause the patient to tearing a lot, in many cases it becomes difficult to open the eye until an anaesthetic agent is instilled to calm down the system a bit.
You may also experience a feeling of a foreign body on the eye and depending on whether the ulcer is sterile or infected, you may get discharges from the eye, let me hasten to add that viral infections however do not produce discharge. You may not be able to tolerate bright lights at all and in some cases you vision may be adversely affected even before treatment.
As mentioned earlier, cornea ulcers may be sterile or infectious however in all cases you Optometrist would give you antibiotics in addition to pain killers and other medication that would enable the cornea heal safely without the formation of scars. If the ulcer have penetrated the layers to the descement’s membrane then scaring may be inescapable.
It is important that you follow the directives of your Optometrist well to ensure that everything is well taken cared of. Some cases may be recurrent in such cases you may need more care and perhaps a change of medication. You may also be given dilation eye drops to help the eye relax and ease the pain. In the case where trauma is involved it may prevent the iris from attaching to the crystalline lens, a condition known as synechiae which could be extremely painful.
In all cases, It is advised that you seek immediate consult from your nearest eye clinic if you believe that you may have developed a cornea ulcer or may have been involved in a situation that could cause your cornea to become ulcerative.
If you have any eye problem see your doctor as soon as possible. Injuries that may not be considered severe could still lead to the development of an ulcer. Wear eye protection when you are around small particles or flying objects. If you have dry eyes or the eyelids don’t close all way, artificial tears can be used to keep the eyes moist.
If you wear contact lens, be careful about how you clean and wear them, never sleep with your contacts in. A corneal ulcer is a medical emergency, without treatment, it might spread to the rest of the eye and could lose some or all of your eyesight in a short time. SEE YOUR DOCTOR FOR TREATMENT.
Byanju, R., Kandel, R. P., Poudyal, B., Bhandari, S., Ligal, A., Pradhan, S., Gautam, M., Shrestha, P., Sah, R. K., Gonzales, J. A., Porco, T. C., Whitcher, J. P., Srinivasan, M., Upadhyay, M. P., Lietman, T. M., Keenan, J. D., O'Brien, K. S., & Village-Integrated Eye Worker Trial Group (2022). Risk factors for corneal ulcers: a population-based matched case-control study in Nepal. The British journal of ophthalmology, bjo-2022-322141. Advance online publication. https://doi.org/10.1136/bjo-2022-322141
Mack, H. G., Fazal, A., & Watson, S. (2022). Corneal ulcers in general practice. Australian journal of general practice, 51(11), 855–860. https://doi.org/10.31128/AJGP-06-22-6453
Ting, D., Chodosh, J., & Mehta, J. S. (2022). Achieving diagnostic excellence for infectious keratitis: A future roadmap. Frontiers in microbiology, 13, 1020198. https://doi.org/10.3389/fmicb.2022.1020198.
Yang, Z., Yu, S., Zhang, C., Agrawal, R., & Feng, Y. (2022). Nonsurgical Management of Severe Viral Keratitis with Hypopyon and Retrocorneal Plaques: A Case Series. Ophthalmology and therapy, 10.1007/s40123-022-00592-x. Advance online publication. https://doi.org/10.1007/s40123-022-00592-x.