Corneal perforation
Corneal perforation - a rupture in the corneal tissue due to traumatic or pathologic processes.
What causes corneal perforation?
- Corneal ulcers are most common cause of perforation.
- Corneal ulcers are caused by an infection with bacteria, viruses, fungi, or a parasite.
- Acanthamoeba keratitis occurs in contact lens users.
- Eyelids that do not close all the way, such as with Bell palsy
- Foreign bodies in the eye
- Scratches (abrasions) on the eye surface
What is gonococcal ophthalmia neonatorum?
Gonococcal ophthalmia neonatorum caused by a maternally transmitted gonococcal infection Unless preventative measures are taken, it is estimated that gonococcal ophthalmia neonatorum will develop in 28% of infants born to women with gonorrhea. It affects the corneal epithelium causing microbial keratitis, ulceration and perforation.
What are the signs and symptoms?
- Blurry or hazy vision
- Eye that appears red or bloodshot
- Itching and discharge
- Sensitivity to light (photophobia)
- Very painful and watery eyes
- White patch on the cornea
What tests are done?
- Exam of scrapings from the ulcer
- Fluorescein stain of the cornea
- Keratometry (measuring the curve of the cornea)
- Pupillary reflex response
- Refraction test
- Slit-lamp examination
- Tests for dry eye
- Visual acuity
- Blood tests to check for inflammatory disorders may also be needed.
What is the treatment?
- Treatment for infections depends on the cause.
- Treatment should be started as soon as possible to prevent scarring of the cornea.
- If the exact cause is not known, broad spectrum antibiotic drops that work against many kinds of bacteria.
- Corticosteroid eye drops may be used to reduce swelling and inflammation in certain conditions.
- Tissue adhesive can be used to seal small perforation, but this method cannot be used to treat perforations larger than 1 mm.
- Non infected corneal perforation generally heals when a pressure bandage is used.
- For certain types of corneal perforations, lamellar keratoplasty is used as treatment.
What are the complications?
Untreated corneal perforations/ulcer and infections may lead to:
- Loss of the eye (rare)
- Severe vision loss
- Scars on the cornea
Can you help answer any of these frequently asked questions on Corneal perforation?
- What happens if your cornea perforates?
- How long does it take for a perforated cornea to heal?
- How do you treat a perforated cornea?
- Can a hole in the cornea heal?
- Can a ruptured eye heal?
- Can cornea repair itself?
- Will my vision come back after corneal ulcer?
- Can a cornea burst?
- Will corneal ulcers heal on their own?
- What causes corneal rupture?
- What causes corneal perforation?
- How do you damage your cornea?
- Is a hole in the eye serious?
- Can you see without a cornea?
- How do you keep your cornea healthy?
- Does a ruptured eye have to be removed?
- Is a ruptured eye painful?
- What is the rupture of the cornea called?
- Can a cornea grow back?
- Can a damaged cornea cause blindness?
- How successful is a cornea transplant?
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Contributors: Prab R. Tumpati, MD