What are corneal ulcers?

A corneal ulcer is an open sore on the cornea. The cornea is the clear dome that covers the coloured iris in the eye and stops dirt or other substances from getting in to your eye. The cornea also helps you to see.

Infections within the eye are the most common cause of corneal ulcers. Infection can occur after an eye injury to the cornea. When the outer layers of the cornea are damaged, infections can enter the eye and cause an ulcer to form.

Corneal ulcers are treatable. If you have any type of eye injury, you should seek medical attention promptly. Even small injuries such as a scratch can cause a corneal ulcer. Proper medical treatment is important to prevent scarring. This can damage your vision, or lead to cataracts or glaucoma.

What are the symptoms of corneal ulcers?

The symptoms of a corneal ulcer differ between individuals and depend on what caused the ulcer. A corneal ulcer might make your eye:

• red and irritated
• painful
• feel like it has something in it
• produce tears or pus
• have blurry vision
• sensitive to bright light (photophobia)
• inflamed or swollen eyelids (blepharitis)

What causes corneal ulcers?

Corneal ulcers are usually caused by eye infections. The infections are often bacterial infections, but they can also be caused by viral infections (such as herpes), fungal infections or physical damage to the cornea.

Some people are more likely to get an eye infection, especially if they touch or rub their eyes a lot. Infections are more common if you:

• wear contact lenses, especially while you sleep or for longer than recommended
• have dry eyes
• have damaged your cornea or had eyelid surgery in the past
• have an underactive immune system or diabetes
• use topical corticosteroids
• have certain eye allergies

An ulcer can also be caused by physical damage to the cornea. Physical damage or trauma to the cornea may happen if:

• a foreign object or small particle gets into your eye
• any chemicals splash into your eye
• other eye-related accidents or injuries occur

When should I see my doctor?

You may experience symptoms that seem more like those of an eye infection before you notice the ulcer itself. You should see your ophthalmologist (medical eye specialist) or doctor if you have these symptoms. This is especially important if over-the-counter eye drops do not cause any improvement within a day.

Immediate medical treatment for a corneal ulcer can help reduce the chance of long-term vision problems.

How are corneal ulcers diagnosed?

Larger ulcers can be seen as a grey or white spot on the cornea, but some ulcers can only be seen with closer examination.

Your doctor or ophthalmologist will check your eyes for foreign particles or injury and then check your vision.

They may then examine your cornea using a special blue light and orange-coloured eye drops that make any ulcers or scratches show up more clearly. These eye drops contain a dye that may stain the surface of your eye slightly yellow, but this will pass after a few hours.

To work out what has caused any underlying infection, your ophthalmologist might take a sample from the ulcer for testing. Samples are usually taken by swabbing the eye discharge or taking a scraping of your cornea and sending these to a laboratory for testing.

How are corneal ulcers treated?

The best treatment for you will depend on the cause of the ulcer and will usually try to treat the underlying cause.

If a foreign body caused the ulcer, your doctor will first remove the object. If your ulcer was caused by dirt, you might be given an anti-fungal medicine.

If an infection is the cause of your ulcer, you will probably be given antibiotic, antiviral or antifungal eye drops. Your doctor will tell you how often and for how long to use these eye drops. It is important to follow their directions because the infection may get worse if not treated properly.

Some antibiotic eye drops used to treat corneal ulcers dilate the pupil (make the black area in the centre of your eye bigger). This can cause blurry vision or make your eyes sensitive to light.

If you wear contact lenses and have a corneal ulcer, you should take the lenses out straight away and avoid wearing them again until 2 weeks after your ulcer has fully healed. Avoid rubbing your eyes and wash your hands before and after you touch your eyes — this helps stop the infection from spreading. A cool compress or over-the-counter pain medicine can give some relief.

Your doctor may suggest that you go to the hospital for monitoring or to help you follow an intensive eye drop treatment schedule.

Corneal ulcers often improve after 2 or 3 weeks of treatment. An ulcer in the centre of the eye might take longer. If you are worried the ulcer is not getting better, contact your doctor or ophthalmologist.

If the ulcer doesn't heal, or leaves significant scarring of the cornea, your ophthalmologist might recommend cornea transplant surgery.

Can corneal ulcers be prevented?

You can help prevent corneal ulcers by taking care of your eyes, and by seeing your doctor promptly if your eyes seem infected or have something in them.

If you wear contact lenses, you can help prevent corneal ulcers. Make sure you:

• clean and store the lenses carefully
• don't wear them for longer than recommended
• avoid wearing contact lenses overnight
• wash your hands well before touching the lenses

If you have dry eye disease, or your eyelids do not close completely, keep your eyes moist with tear-substitute eye drops.

To avoid getting dirt or objects in your eye, wear goggles to protect your eyes from flying particles — for example, when you are gardening or using power tools.

Complications of corneal ulcers

Without proper and immediate treatment of a corneal ulcer, you are at risk of developing:

• corneal scarring and/or perforation (a hole in the cornea)
• glaucoma
• cataracts
• long-term vision loss

After the ulcer begins to heal, it might leave a scar on your cornea blurring your eyesight. This scarring should fade with time and vision will improve.

See your doctor or an ophthalmologist to learn how to reduce your chance of complications.

Resources and Support

• Vision Australia has helpful resources on

To learn more about how to take care of your contact lenses, see:

• Contact Lenses — Vision Australia
• Contact Lens Care — Cornea and Contact Lens Society of Australia

To book an eye test or find an optometrist near you visit Optometry Australia.

Looking for information for Aboriginal and/or Torres Strait Islander people?

Visit the page on Aboriginal eye health on the Sight for All website.