A corneal ulcer is any open sore on the cornea. Bacteria or fungi introduced into the cornea through the corneal epithelium is usually the cause. Corneal ulcers are becoming more common because of the increase in the use of contact lenses.
Instructions
1. Gather the patient history. Contact lenses, injuries or surgeries to the eye and medications for the eyes such as topical steroids can cause corneal ulcers. They commonly cause inflammation of the eyelids and conjunctiva, discharge from the eyes, the sensation of a foreign body in the eye, blurred vision and a sensitivity to light.
2. Conduct an eye examination. Staining with fluorescein may be able to identify a herpes simplex virus. An ulcer that fluoresces under a Wood lamp may indicate a Pseudomonas aeruginosa infection.
3. Differentiate a corneal ulcer from other conditions that may have similar symptoms. These include blepharitis, a foreign body in the cornea, a Mooren ulcer and Terrien degeneration.
4. Conduct laboratory studies. Do a culture of the corneal ulcer, and a scraping of the ulcer also may be needed. Evaluate the patient for rheumatoid arthritis which carries an increased risk for corneal ulcers.
5. Identify the causative organism in cases of corneal ulcers caused by bacteria. The most common cause of corneal ulcers in the United States is the Herpes simplex virus. A culture is usually necessary, but a bluish or greenish discharge from the eyes is almost diagnostic of a Pseudomonas aeruginosa infection.
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