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A corneal ulcer is a loss or erosion of the corneal stroma with an
overlying epithelial defect usually secondary to an infectious agent.
However, corneal ulcers may also be sterile (non infectious) in nature.
Infectious ulcers are usually associated with infiltrates or whitish
accumulations of pus and inflammatory agents within the corneal stroma.
This whitish lesion may be seen with the naked eye if it is large
enough.
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An intact corneal epithelium acts as a barrier to infectious agents. Any
break in this epithelial barrier can thus, predispose to corneal ulcers.
Conditions that reduce corneal epithelial integrity include trauma and
abuse of contact lenses. Any structural abnormality of the eye such as
inward turning of the lashes and incomplete eyelid closure can also lead
to epithelial destruction and ultimately corneal infections. In
addition, toxicity secondary to medications and immunosuppressed states
(long standing illnesses, diabetes, chronic steroid use etc.) all
predispose to corneal ulcers by potentially destroying the corneal
epithelial epithelial barrier.
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Corneal ulcers are generally caused by bacterial, viral or fungal
agents. These causative agents may all present in the same manner but
an accurate history as taken by the physician will aid in pointing out
the correct infectious microorganism. A history of trauma with vegetable
or plant matter should always alert the ophthalmologist of a possible
fungal cause. Vesicles or blisters around the eyelid / eyelid margin
associated with corneal lesions may be due to the herpes virus.
Bacterial corneal ulcers may present in many ways although a history of
contact lens wear may predispose to Pseudomonas infections.
The definitive diagnosis is arrived at through corneal smears and
cultures which can be performed in the clinic on an out patient basis.
With the results of these cultures, a more definitive treatment plan can
be formulated. It is important to consult an ophthalmologist in order to
arrive at an accurate diagnosis and to institute the proper therapy.
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Once the suspected infectious microorganism is identified, the proper
therapeutic agents may be instituted. Usually, topical drops are used
which are either of the following: antibiotics, antifungals or
antivirals. Patients are conventionally treated on an out patient basis
and rarely will confinement be required. However, the patient may be
given the option of staying in the hospital if: a) the ulcer is large
enough and the patient cannot comply with frequent eye drops; b) the
patient has to travel a long distance in order to follow up; c) if
intravenous antibiotics or surgery are contemplated.
Oral medications (antibiotics, antifungals or antivirals) may also be
given as adjunctive therapy if the infectious load is too large.
Steroids, and cycloplegic drops may also be administered at the
discretion of the attending physician. In cases of impending corneal
perforations, surgery ( corneal transplant, conjunctival flaps) will be
considered.
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When corneal ulcers are detected at an early stage, prognosis is usually
good with complete elimination of the infecting organism and a small
corneal scar, at most. If the scar crosses the pupil, however, the
vision may be impaired. Neglected ulcers are often more difficult to
handle because of the increased possibility of perforation. In cases of
perforated ulcers, the eye may be lost and a corneal transplant may be
necessary in order to preserve the eye’s structure. It is important to
advise the patient that, although the eye remains intact after a
transplant, visual rehabilitation takes a long time. Vision is preserved
but often still inferior to eyes which have never been injured.
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How
do I get more information?
There are several ways of reaching the ophthalmologists of EYE REPUBLIC Ophthalmology Clinic:
Hover note: Please place your mouse cursor over the red box
to click on the web and email links. For websites, a new browser
window will open. For emails, your default email program will
open. You may cut and paste the URLs or email addresses if you
prefer not to open new windows.
ONLINE ACCESS
WEBSITES.
http://www.EyeRepublic.com.ph - EYE REPUBLIC
Ophthalmology Clinic
http://www.OCP.com.ph - Ophthalmic
Consultants Philippines Co. -
http://www.LASIK.com.ph - Refractive
Surgery Resource
http://www.Cataract.com.ph - Cataract Surgery Resource
http://www.Eye.com.ph - Eye
Information Online
http://www.EyeDoc4Kids.com.ph - Eye Information for Kids
http://www.Retina.com.ph - Retina
Surgery Resource
http://www.Glaucoma.com.ph - Glaucoma
Online
http://www.Uveitis.com.ph - Uveitis Online
EMAIL. After writing down your comments,
suggestions, problems and/or questions, kindly tell us how
to get in touch with you by providing your name, email,
home/office numbers, and mobile phone.
General inquiries - help@EyeRepublic.com.ph
Refractive Surgery Service - refractive.surgery@EyeRepublic.com.ph
Glaucoma Service - glaucoma@EyeRepublic.com.ph
Cataract Service - cataract@EyeRepublic.com.ph
Doctors - eyemd@EyeRepublic.com.ph
Administrative - president@EyeRepublic.com.ph
Website - webmaster@EyeRepublic.com.ph
Newsletter -
newsletter@EyeRepublic.com.ph (receive
news and updates, discounts and promotions)
BLOG. Send us your comments.
EYE REPUBLIC
Ophthalmology Atlas
CLINIC INFORMATION
Mobile E-Yellow Pages. Via
SMS, text LUK4 EYEREPUBLIC
(send to 2851 for Globe and Sun Cellular, and 2951 for Smart). |
EYE REPUBLIC Ophthalmology Clinic
Manila
3/F Don Santiago Building Units 309-310
1344 Taft Avenue, Ermita
Manila, 1000 Philippines
Direct and Fax: (632) 536-2398
Trunk Line: (632) 523-8271 to 79 local 30
Mobile: (63917) 899-2020
Map and directions
|
EYE REPUBLIC
Ophthalmology Clinic
Asian Hospital
and Medical Center
5/F Medical Office
Building (MOB) Suite 509
2205 Civic Drive,
Filinvest, Alabang
Muntinlupa City,
1781 Philippines
Direct:
(632) 771-9253
Direct and Fax:
(632) 771-9254
Mobile: (63917) 795-2020
Map and Directions
|
EYE REPUBLIC Ophthalmology Clinic
Medical City
6/F Medical Arts Tower Inc (MATI) Suite 602
MERALCO Compound, Ortigas Avenue
Pasig City, 1604, Philippines
Direct and Fax: (632) 632-7846
Mobile: (63917) 537-2020
Map and directions
|
EYE REPUBLIC
Ophthalmology Clinic
St. Luke's
Medical Center
6/F
Cathedral Heights Building Complex (CHBC)
North Tower Suite 614
279 E. Rodriguez
Sr. Boulevard
Quezon City, 1102
Philippines
Direct and Fax:
(632) 407-3883
Mobile: (63917) 855-2020
Map and directions
|
CLINIC HOURS
First-Come, First-Served
Monday to Saturday 9:00 AM to 6:00 PM
All clinics are closed on Sundays and Holidays
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INFECTIOUS CORNEAL ULCER information
compiled by
Dr.
Johann Reyes and initially uploaded on February 11, 2006.
Last updated on
September 13, 2007. |
