Corneal ulcer – inflammation of the cornea, accompanied by necrosis of the epithelium and stroma with the formation of a defect.
Ulcers can be either sterile (free of pathogenic viruses) or infectious. Around the ulcer, there is almost always a so-called. infiltrate, local turbidity caused by the accumulation of inflammatory cells and fluid.
All ulcerative lesions of the cornea can be divided into two groups: infectious and non-infectious. Among the infectious lesions of the cornea in terms of frequency, herpesvirus, bacterial, fungal and parasitic (acanthamoeba) are in the first place, among non-infectious ones – corneal erosion, an ulcer of immune genesis, an ulcer in the “dry eye” syndrome and in primary or secondary corneal dystrophy.
A corneal ulcer usually arises from cracks in the cornea. In addition, it can appear at the site of injuries and wounds of the eye. It is important to understand that cracks and injuries can be very minor, invisible to the patient himself. Each of us, who at least once in his life got a knot in his eye, cannot be one hundred percent sure that the integrity of his cornea is not broken. The cornea has a great ability to heal itself, and after a few months after a small injury, it usually recovers completely. However, in some cases this does not happen and an ulcer occurs at the site of the injury.
The key symptom of an ulcer is pain. Naturally, after an eye injury, pain is present. However, we are talking about an increase in pain. If, after the incident, the pain stabilized and even began to subside, and after a couple of days (or weeks) it suddenly increased again, then the formation of an ulcer is very likely. Photophobia and lacrimation are also fairly typical “markers” of an ulcer. They also do not often accompany injuries, and it is not the presence of these symptoms that is diagnostically important, but their pronounced increase after a certain period of time.
Sometimes the described signs are found, as it were, against the background of complete health. This traditionally occurs when the initial injury was minor and the patient had already forgotten about it, while the inflammation increased in the meantime, and the ulcer began to form.
The appearance of an ulcer is not often accompanied by reddening of the whites of the eye. An ulcer responds relatively well to treatment, but if the moment is missed, the disease can take a dangerous and very serious turn. The insidiousness of the ulcer is as follows. Firstly, the defect can progress deeper, and the ulcer gradually turns into a through tunnel connecting the external environment and the very bowels of the eye. This is an extremely “shared state”, for microbes can penetrate into the very depths of the eye without encountering any resistance in their path. This can provoke the development of panophthalmitis (this disease will be discussed below).
Secondly, ulcers sometimes have the ability to grow, not in depth, but in breadth. Predicting such features of the “character” of an ulcer is incredible. In such cases, the term “creeping ulcers” is used. They progress very quickly, capturing more and more territory in a matter of days. The main trouble is that at the site of the ulcer, after its healing, very often there remains a small scar and traces of sprouted vessels, and these structures do not let light through, and therefore a spot will forever “loom” in the field of vision at the site of the scar. Such ulcers tend to “spread” quite strongly over the eye, and therefore the trace of them after recovery can be very large.
Duration of the disease, severity of symptoms, pain, photophobia, discharge, decreased visual acuity.
Since an ulcer is a microbial (bacterial) disease, the main component of its treatment is antibacterial products (antibiotics, sulfonamides, etc.). They are used in the form of drops, ointments, also in the form of tablets (later – if the disease takes a heavy turn).
As an additional remedy, hormones are not often prescribed (they have practically no effect on bacteria, but they effectively help relieve inflammation).
Physiotherapeutic methods also play an important role in the treatment of ulcers. In the first phase of the disease, techniques such as ultrasound and X-ray therapy help to put out the “fire of inflammation”. However, physiotherapy really comes to the fore when the microbe is suppressed, and inflammation begins to subside. During this period, it is very important that the area of the ulcer overgrows as neatly as possible, without coarse scars (so that vision does not deteriorate). To this end. Electrophoresis is used (with vitamins and minerals).