Symptoms depend on the size and depth of the ulcer, the condition of the cornea and whether or not there is an infection. The cornea is extremely sensitive, so even small corneal abrasions can cause a watering eye, redness and possibly sharp pain.
A thorough ophthalmological examination will be carried out, including an evaluation of vision, eyelids and the eye surface. The upper lid is everted to look at the inner surface, and check for foreign bodies. If there is an infection, the ophthalmologist will take a sample of the cornea, a corneal scrape, to do a microbiology study, as this can be very useful to help decide on treatment.
Small corneal abrasions are usually treated with antibiotic ointment, eye lubricants and an eye pad. They usually heal the same day.
Larger or extensive corneal abrasions are more painful and the risk of infection is higher. Treatment is with antibiotics (usually ointment) and eye lubricants, with an eye pad. Even extensive corneal abrasions usually heal within a few days.
Infected corneal ulcers are a serious condition that can lead to permanent loss of vision. If a corneal infection is diagnosed, the ophthalmologist will take a corneal scrape sample for microbiological study and start treatment immediately. Treatment is based on antibiotics drops that may need to be used hourly. It is not advisable to use an eye pad as this can worsen the corneal ulcer. Drops to dilate the pupil are also used. A large corneal ulcer may take several weeks to heal.
If the cornea becomes cloudy after an ulcer (corneal scar or leucoma), further treatment from a corneal specialist may be necessary to improve vision.
Soft contact lens wearers who develop a corneal ulcer should seek urgent ophthalmological examination as they are prone to more serious infections which, if left untreated, can lead to loss of vision.