Corneal Ulcers: Causes, Treatment, and Concerns

Q: Corneal Ulcers: Causes, Treatment, and Concerns

Hello： Your condition may be due to external trauma to the eye, resulting in corneal damage, although the initial abrasion may not have been very apparent or may not have occurred at that time. <br>However, over time, your symptoms have worsened, ultimately leading to corneal abr

Corneal ulcer

Hello, doctor.
Recently, I experienced an impact to my right eye.
At the time, both of my eyes were experiencing allergies, and it was visibly apparent that my eyelid was scratched.
When I sought medical attention, I only mentioned discomfort in my eyes and did not mention the impact, so the doctor diagnosed it as an allergy.
However, the next day it progressed to a corneal abrasion, and by the following day, it became infected.
I would like to ask why it transitioned from an allergy to a corneal abrasion in just one day.

Currently, I am using Crfa 1000mg/vial (Cefazolin Sodium) and Levofloxacin eye drops, applying them every hour.
Will using these two medications for over a week cause any harm to my eyes? Additionally, should I space the two medications 5 minutes or 10 minutes apart? If there is an ointment to use as well, how long should I wait between using the ointment and the eye drops? How should I apply the drops correctly—should I place them directly in the eye or on the lower eyelid? I often find it difficult to accurately apply the drops and sometimes end up applying an extra drop out of uncertainty.
Lastly, my corneal infection has persisted for 11 days without significant improvement, and the bacterial culture has not yielded any results.
Could this lead to any long-term complications? Thank you, doctor, for your attentive response amidst your busy schedule!

Niming, 20~29 year old female. Ask Date: 2023/03/13

Dr. Gao Pilin reply Ophthalmology

Hello: Your condition may be due to external trauma to the eye, resulting in corneal damage, although the initial abrasion may not have been very apparent or may not have occurred at that time.
However, over time, your symptoms have worsened, ultimately leading to corneal abrasion and infection.
As for the medications you are currently using, Cefazolin Sodium and Levofloxacin are common antibiotics used to treat ocular infections.
Regarding the frequency and interval for instilling eye drops, it is best to follow your physician's recommendations, as this depends on your individual situation and the severity of your symptoms.
Generally, the interval for instilling eye drops should be 5 to 10 minutes.
If there is no improvement after more than a week, it is important to continue treatment.
For the use of ointment, it is advisable to apply it after using the eye drops.
Place the medication in the inner lower eyelid and then close your eyes to allow the medication to spread evenly across the surface of the eye.
Given that your infection has persisted for over 11 days without significant progress, it is best to seek medical attention again and consult your physician.
The physician will adjust your treatment plan based on your condition.
Therefore, please closely cooperate with your physician.
The potential complications of corneal ulcers include corneal scarring and vision deterioration.

Reply Date: 2023/03/13

More Info

Corneal ulcers, also known as corneal ulcers or keratitis, are serious eye conditions that can lead to vision loss if not treated promptly and effectively. They can be caused by a variety of factors, including infections (bacterial, viral, or fungal), trauma to the eye, dry eyes, or underlying health conditions. In your case, it appears that the initial injury to your eye, combined with an allergic reaction, may have led to the development of a corneal ulcer.

When the eye is injured, the protective barrier of the cornea can be compromised, making it more susceptible to infections. Allergic reactions can cause inflammation and irritation, which may further exacerbate the situation. It is not uncommon for a seemingly benign allergic reaction to escalate into a more serious condition like a corneal ulcer, especially if there is an underlying injury that has not been properly addressed.

Regarding your current treatment regimen, you mentioned using Cefazolin Sodium (Crfa) and Levofloxacin eye drops. Both of these medications are antibiotics used to treat bacterial infections. Cefazolin is typically used for more serious infections, while Levofloxacin is a fluoroquinolone antibiotic effective against a broad range of bacteria. It is essential to follow your doctor's instructions regarding the frequency and duration of these medications. Using them for more than a week can sometimes lead to complications, including antibiotic resistance or potential side effects, but this largely depends on the specific circumstances of your infection and your overall eye health.

As for the administration of the eye drops, it is generally recommended to wait about 5 to 10 minutes between different eye drops to ensure that the first drop has time to be absorbed before applying the second one. If you are using an ointment in addition to the drops, it is usually advised to apply the ointment after the drops, allowing at least 10 minutes between the two. When applying eye drops, it is best to tilt your head back slightly, pull down the lower eyelid to create a small pocket, and then place the drop in that pocket without letting the dropper touch your eye or eyelid to avoid contamination.

If your corneal infection has persisted for 11 days without significant improvement and the bacterial culture has not yielded results, it is crucial to follow up with your eye care specialist. Persistent infections can lead to complications such as scarring of the cornea, which may affect your vision. In some cases, if the infection does not respond to initial treatment, further testing or a change in treatment strategy may be necessary.
In summary, corneal ulcers are serious conditions that require prompt and appropriate treatment. It is essential to adhere to your prescribed medication regimen, follow proper techniques for administering eye drops, and maintain regular follow-up appointments with your eye care provider to monitor your condition and prevent potential complications. If you notice any worsening of symptoms, such as increased pain, redness, or vision changes, seek immediate medical attention. Your eye health is critical, and timely intervention can make a significant difference in your recovery.

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