What is a Corneal Ulcer?

For over a month, my aging mother has struggled with eye irritation. Initially, their Health Partners doctor figured it was conjunctivitis or pink eye. The symptoms were consistent with such a diagnosis:

• Blurred vision
• Crusts that form on the eyelid overnight
• Eye pain
• Gritty feeling in the eyes
• Increased tearing
• Itching of the eye
• Redness in the eyes
• Sensitivity to light

Mom was given mild antibiotic eye drops to administer every two hours and also told to apply cool compresses to the affected area. My stepfather made certain this procedure was followed to the letter. He even rushed her through long distance phone calls if it was time to apply the eye drops. He was anxious to help her get past this annoying irritation.

But little changed. Mom continued to experience itching, although the redness disappeared. She remained sensitive to light and the eye felt gritty and blurred. She avoided social events, preferring to stay home and rest.

The second doctor visit confirmed that an infection still existed. The type of eye drops was changed, but again this had little affect.

On the third visit, an eye specialist spent over an hour examining the eyes, getting second opinions and evaluating what was now a bump on mom's inner cornea by means of a slit-lamp examination, fluorescein stain, and microbial studies.

The third doctor is of the opinion that a second infection has occurred. He labeled the current problem a corneal ulcer.

A corneal ulcer is an open sore on the cornea, which covers the colored part of your eye called the iris. Such an ulcer is caused when bacteria, a fungus, a virus, or- heaven forbid- acanthamoeba moves into the area. (See video to the right- ugh.)

A corneal ulcer can also occur due to contact lenses or vitamin a and protein deficiencies. Symptoms include:

• progressive redness
  
• foreign body sensation
  
• ache
• light sensitivity
  
• eyes tear up

In my mother's case, it appears that her ulcer was caused by the herpes simplex virus. You are probably familiar with oral herpes, which often causes cold sores. Mom's corneal ulcer was caused by a similar virus.

As with all herpes simplex virus infections, the person experiences an initial infection, after which the virus becomes dormant, settling into nerve roots. Symptoms tend to recur at some future date.

To combat my mother's infection, the eye doctor prescribed acyclovir, which might be sold under the brand name Zovirax®.

This drug is cautionary for the elderly, as older folk are at higher risk for Central Nervous System problems, liver failure, and gastrointestinal tract issues while taking undergoing treatment. (Although it seems oral injestion is less of a concern than taking it intravenously.)

Drugs make me very nervous; my mother is 82. "How did I get this old," she laughs adding, "I used to think 82 was old!"

My brother the dentist assures me that, while he used to worry about prescribing acyclovir for herpes of the mouth, this drug has been around a long time. He will keep my concerns in mind when next he speaks with Mom.

FYI, Acyclovir is not recommended for pregnant or lactating women.