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.

This was a newborn with gonococcal ophthalmia neonatorum caused by a maternally transmitted gonococcal infection

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

FAQS

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?

Resources

Frequently asked questions

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