Deep Corneal Stromal Ulcer

rDVM Quick Reference Guide for this Ophthalmic Emergency

  • Physical Examination
  • Topical Antimicrobials
  • Culture, if indicated
  • Systemic Antimicrobials
  • Avoid Topical Anti-Inflammatories
  • Systemic Analgesia
  • E-Collar to Prevent Self-Trauma
  • Consider Referral for Surgical Evaluation and Treatment

Deep corneal stromal ulcers are typically the result of trauma and/or infection of a superficial ulcer. A brief physical examination should be performed, and evaluation of tear production via a Schirmer Tear Test and corneal culture should be considered. Aggressive medical therapy is necessary to treat corneal infection, minimize intraocular inflammation, and maintain patient comfort. Treatment typically comprises topical and systemic antimicrobials, systemic anti-inflammatories, and systemic analgesia. An Elizabethan collar should be placed to prevent self-trauma. Referral for intensive medical management and/or surgical intervention should be strongly considered.