Anterior most transparent layer of the eye is called cornea. It is an extremely useful layer for refraction and protection of eye.
Any trauma, foreign body or chemical etc can invade the integrity of this layer and can be invaded by bacteria, fungus or virus, resulting in the corneal ulcer. Sometimes, due to hypoxia induced by contact lenses too can result in a corneal ulcer.
Depending on clinical presentation, a doctor diagnoses the cause of the ulcer and starts the therapy. Since the transparency of cornea is very important, a doctor may start with very intensive therapy depending upon the cause and extent of infection. In spite of repeated frequent checkups, if proper and intensive therapy is not given, the ulcer can progress and can cause collection of pus in the eye (anterior chamber) which if not attended properly, can cause the infection to travel into the interior of the eyeball (vitreous chamber) resulting in total blindness. The ulcer can become deeper and lead to perforation of the cornea, causing severe damage to the eye and may require removal of eyeball also.
Generally, fungal ulcers are more dangerous and occur mostly in rainy season or with a minor trauma also resulting from an injury with a vegetative matter like leaf, wood, plants etc.
It is imperative that a case of corneal ulcer be diagnosed promptly and very intensive and proper treatment is given to save the disfigurement of the eye and total irreparable loss - blindness.
At times, with topical eye drops, oral therapy also has to be given. Injections in the eye may also be required in severe cases. Culture sensitivity also has to be done in severe cases to identify the causative organism for proper treatment.
In extremely severe cases, we may have to perform, therapeutic keratoplasty.
Conclusion: Corneal Ulcer is a serious challenging problem with the potentiality to cause total and irreparable blindness and must be attended promptly by a very expert ophthalmologist to save the eye.