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What is the difference between a corneal ulcer and a corneal abrasion?

Both corneal ulcer and corneal abrasion cause a very painful red eye. Corneal abrasion is particularly painful. It can be caused by a baby’s fingernails, piece of paper, stick in the garden, something falling in. And it means that the very fine, highly sensitive layer of the cornea, called the epithelium, abrades off. And because the cornea, which is the clear bit if the front of the eye, is so sensitive, it becomes very painful.
However, the good news is that it’s very short lived. It will recover with the appropriate medical treatment over 24 hours and a maximum of 36 hours.
Now, a corneal ulcer can be something more serious. Corneal ulcer is more in contact lens wearers. They have a painful eye and it’s red. It may not be quite as red as in a corneal abrasion. When we examine them on the slit lamp, I can see that there is a little area of infiltration. Meaning, a little area that has gone white. That can represent either an infection with a bacteria or a mereological response. In other words, a very  severe inflammation of the cornea.
That has to be treated intensively, medically. You may have to take some  little bacteroidal swaps if I’m suspecting an ulcer. Particularly if you are a contact lens wearer, it can be a corneal ulcer that is called Acanthamoeba. And I need to know whether it’s that or a very severe one a pseudomonas. That has to be treated with specific antibiotics every hour, day and night.

More about Jane Olver

Ms Jane Olver is the founder of Clinica London and a Consultant Ophthalmologist and Oculoplastic Surgeon. Her special expertise is in oculoplastic and cosmetic eye surgery including eyelids and lacrimal surgery. She is specialised in endoscopic lacrimal surgery for watering eyes in adults and children. She has over 20 years’ experience in treating people with eye problems just like you, and has published extensively in scientific journals about Ophthalmology and Lacrimal Surgery and is the author of the books “Ophthalmology at a Glance” and “Colour Atlas of Lacrimal Surgery”. At Clinica London, she is responsible for the Aesthetic Medicine and Surgery part, as well as patients with eye, eyelid and tear duct problems, and acute eye problems.


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