Corneal Ulcers: What Contact Lens Wearers Need to Know About Risks and Emergency Care
Jan, 19 2026
A corneal ulcer isn’t just a sore eye-it’s an open wound on the clear front surface of your eye that can steal your vision if ignored. For the 85 million people worldwide who wear contact lenses, this isn’t a rare scare. It’s a real, preventable danger. And the clock starts ticking the moment you feel pain, notice blurred vision, or see a white spot on your eye. This isn’t something you wait out. This isn’t something you treat with over-the-counter drops. This is an emergency.
What Exactly Is a Corneal Ulcer?
The cornea is your eye’s clear, protective dome. It’s not just a window-it’s a living tissue that needs oxygen, moisture, and protection. A corneal ulcer is when that surface breaks down, forming an open sore. It’s not a scratch. It’s not redness. It’s tissue loss. And it’s almost always caused by infection. Unlike a simple corneal abrasion, which is a surface scrape that usually heals on its own, a corneal ulcer eats into the deeper layers. Bacteria, fungi, or even a tiny amoeba called Acanthamoeba can invade through a tiny crack or under a lens, then multiply fast. Left untreated, the infection can perforate the cornea, cause permanent scarring, or lead to blindness. The most common trigger? Wearing contact lenses, especially overnight. A contact lens wearer is 10 times more likely to get a corneal ulcer than someone who doesn’t wear lenses. If you sleep in them? That risk jumps to 100 times higher. It’s not hype. It’s data from the Cleveland Clinic and the FDA.Why Contact Lenses Are the #1 Risk Factor
It’s not the lenses themselves-it’s how they’re used. Soft contact lenses, especially extended-wear types, act like a sealed dome over your cornea. That blocks oxygen. Your eye starts to suffocate. At the same time, your fingers, your cleaning solution, your shower, your tap water-they all carry germs. When you insert a lens, you’re not just putting plastic on your eye. You’re trapping a biofilm of bacteria, fungi, or worse, right against your cornea. Here’s how it happens:- You wear your lenses longer than recommended-say, a week past the 2-week replacement date.
- You rinse them with tap water because you ran out of solution.
- You sleep in them because you’re too tired to take them out.
- You reuse the same case for months without cleaning it.
- You swim or shower with them in.
Red Flags: Don’t Wait for the Pain to Get Bad
The biggest mistake people make? Thinking it’s just “dry eye” or “a tired eye.” Corneal ulcers don’t start with mild discomfort. They start with warning signs that are easy to ignore. Here’s what to watch for:- Blurry or hazy vision-not just foggy, but like looking through a dirty windshield.
- Severe eye pain-not a dull ache, but sharp, burning, or throbbing.
- Red or bloodshot eye-not just a little pink, but deep, angry red.
- White or gray patch on the cornea-you might see it in the mirror if you’re lucky.
- Light sensitivity-even normal indoor lighting hurts.
- Excessive tearing or pus-like discharge-your eye is trying to flush out the infection.
- Itching or feeling like something’s stuck-even when you know there’s nothing there.
How Doctors Diagnose a Corneal Ulcer
You can’t diagnose this yourself. You need specialized tools. Your eye doctor will likely do this:- Fluorescein staining-they drop a harmless orange dye in your eye. Under blue light, any damaged areas glow green, showing the exact size and shape of the ulcer.
- Slit-lamp exam-a high-powered microscope with a bright light lets them zoom in on the cornea, seeing layers you can’t even imagine.
- Corneal scraping-if the ulcer looks serious, they gently scrape a tiny bit of tissue to send to a lab. This tells them if it’s bacteria, fungus, or something else.
- Visual acuity test-they check how well you can see before and after treatment.
What Happens If You Don’t Treat It
This isn’t a “maybe” scenario. Untreated corneal ulcers lead to one of three outcomes:- Permanent scarring-the cornea heals with cloudy tissue, blurring your vision forever.
- Corneal perforation-the hole gets so deep, your eye leaks fluid. This can cause the eye to collapse.
- Blindness-the infection spreads inside the eye or causes irreversible damage to the optic nerve.
Treatment: It’s Not One-Size-Fits-All
Treatment starts the moment you walk in the door. No waiting for lab results. No “let’s see how it goes.” For bacterial ulcers-which make up the majority-doctors start with strong antibiotic eye drops. Fluoroquinolones like moxifloxacin or gatifloxacin are the go-to. You’ll need to apply them every 30 to 60 minutes at first, then taper off. For fungal ulcers-often from contaminated water or soil-antifungal drops like natamycin are used. These are harder to treat and take weeks. For viral ulcers-usually from herpes simplex virus-antivirals like acyclovir or ganciclovir are prescribed. If the ulcer is large (over 2 mm), close to your pupil, or getting worse after 48 hours, it’s considered “sight-threatening.” That means immediate culture testing and stronger treatment. Sometimes, you’ll need hospitalization for IV antibiotics. Important: Steroid eye drops might sound like they’d help with swelling-but if you use them without knowing the cause, they can make a fungal or viral infection explode. Only use them if your doctor specifically prescribes them. If the scar is thick and blocks your vision after healing, a corneal transplant might be your only option. That’s major surgery. And it’s preventable.
How to Prevent a Corneal Ulcer-For Good
You don’t have to give up contacts. But you do have to treat them like medical devices-not accessories. Here’s what works:- Never sleep in your lenses-even if they’re labeled “extended wear.” The 100x risk increase is real.
- Replace lenses on schedule-daily, biweekly, monthly. Don’t stretch them.
- Wash your hands-every single time you touch your lenses. Soap and water. Dry with a lint-free towel.
- Use only the solution your doctor recommends-never tap water, saliva, or homemade saline.
- Replace your lens case every 3 months-and rinse it daily with solution, not water. Let it air-dry upside down.
- Take them out for swimming, showering, and hot tubs-water is the #1 source of Acanthamoeba.
- Give your eyes a break-wear glasses at least one day a week.
- Don’t wear lenses if your eyes are red, dry, or irritated-that’s your body’s alarm.
What to Do If You Think You Have One
Step 1: Take out your contacts. Immediately. Don’t clean them. Don’t reuse them. Throw them away. Step 2: Don’t rub your eye. Don’t put anything in it. Not drops, not water, not tea bags. Step 3: Call your eye doctor. If they’re not available, go to an emergency eye clinic. In Melbourne, clinics like the Royal Victorian Eye and Ear Hospital or private urgent eye care centers can see you same-day. Step 4: Bring your lens case and solution with you. The doctor might need to test them. Step 5: Follow every instruction. Even if you feel better after a day, finish the full course of drops. Stopping early invites resistance and recurrence.Final Reality Check
Contact lenses are safe-when used correctly. But “correctly” isn’t a suggestion. It’s a rule. The technology has improved. The materials are better. But human error? That hasn’t changed. Every year, people lose their vision because they thought, “It’s probably nothing.” Or, “I’ll wait until Monday.” Or, “I’ve worn them like this for years.” Your eyes don’t come with a backup. Once the cornea is scarred, you can’t undo it. But you can prevent it. If you wear contacts, treat them like your life depends on it-because it does.Can a corneal ulcer heal on its own?
No. A corneal ulcer is an infected open wound. It won’t heal on its own. Left untreated, it will worsen, leading to scarring, perforation, or blindness. Even if pain seems to improve, the infection can still be spreading beneath the surface. Medical treatment is required.
Can I still wear contacts after having a corneal ulcer?
Not until your eye doctor says it’s safe. After healing, you may need to switch to daily disposable lenses and follow stricter hygiene rules. Some people are advised to stop wearing contacts permanently, especially if they’ve had multiple ulcers. Your doctor will assess your eye’s health and risk factors before giving clearance.
Are daily disposable lenses safer than monthly ones?
Yes. Daily disposables reduce the risk of infection because you throw them out every day-no cleaning, no storage, no biofilm buildup. Monthly lenses require consistent cleaning and case hygiene, which many people skip. For people prone to eye infections, daily lenses are the safest option.
Can I use eye drops from the pharmacy for a suspected ulcer?
No. Over-the-counter drops may relieve redness or dryness, but they won’t treat an infection. Some contain steroids that can make a fungal or viral ulcer worse. Only use eye drops prescribed by an eye care professional after a proper diagnosis.
How long does treatment for a corneal ulcer take?
Mild ulcers may improve in 1-2 weeks with daily antibiotic drops. Severe or sight-threatening ulcers can take 4-6 weeks or longer. Healing depends on the cause, size, and how quickly treatment started. Follow-up visits are essential-even if you feel better.
Thomas Varner
January 20, 2026 AT 18:30Just saw a guy at the gas station with a red eye and contacts in-no joke, he was scrolling on his phone like nothing was wrong. I wanted to scream. This post? 100% needed. People treat their eyes like they’re disposable. They’re not. Your cornea doesn’t get a do-over.
Crystal August
January 22, 2026 AT 11:39Ugh. Another fear-mongering article. I’ve worn my lenses for 12 years, slept in them twice, and my vision’s perfect. You’re scaring people for clicks. Stop it.
thomas wall
January 24, 2026 AT 07:57While I appreciate the urgency conveyed in this piece, I must respectfully contend that the tone, though well-intentioned, borders on alarmist. The statistics cited are indeed compelling, yet the absence of nuance regarding individual anatomical variance and hygiene practices may inadvertently discourage responsible lens wearers from seeking appropriate care. The cornea is a resilient organ, but it demands respect-not panic.
Art Gar
January 26, 2026 AT 07:02Let’s be clear: this is not a medical advisory. This is a marketing piece disguised as public health education. The FDA does not issue warnings like this. The Cleveland Clinic does not publish fear-based infographics. This is designed to sell daily disposables and emergency visits. You’re profiting off anxiety, not saving eyes.
Edith Brederode
January 27, 2026 AT 06:09Thank you for this. 🙏 I had a tiny ulcer last year and thought it was just dry eyes. Turned out I’d been using tap water to rinse my case for months. I cried in the doctor’s office. Now I only use dailies, replace my case every 90 days, and wash my hands like I’m about to perform surgery. It’s not hard. It’s just non-negotiable.
Nadia Watson
January 27, 2026 AT 11:32I’ve been an optician for 18 years and I’ve seen too many people lose vision because they thought "it’ll go away." One guy came in with a ulcer the size of a pea-he said he "just forgot" to take his lenses out for three nights. He’s blind in that eye now. This isn’t hype. It’s the truth. If you wear contacts, treat them like insulin. Miss a dose? You’re in trouble. Don’t gamble with your sight.
Also, if you’re using tap water to clean your case? You’re basically giving your eye a bath in bacteria. I’ve had patients bring me their cases and I’ve seen mold growing in the corners. That’s not gross-it’s dangerous.
And yes, daily disposables are safer. Not because they’re expensive, but because they eliminate the entire cleaning ritual. No case. No solution. No risk. Just pop in a fresh one. It’s the easiest way to stay safe.
Also, if you’re swimming with contacts? You’re inviting amoebas to a party. Acanthamoeba doesn’t care if you’re young or healthy. It just wants a warm, wet surface. Your eye is perfect.
And no, eye drops from the drugstore won’t fix it. Those are for redness, not infection. Using them is like putting a bandaid on a broken leg.
And if you think you can "wait until Monday"? You’re not being patient. You’re being reckless. Your eye doesn’t keep business hours.
And yes, steroids can make things worse. I’ve seen it. A patient comes in with a viral ulcer. Doctor says no steroids. Patient finds some online. Two weeks later? Cornea melted. I’ve seen it. It’s not a myth. It’s real.
And if you’re still wearing monthly lenses? You’re not being thrifty-you’re being lazy. That case? It’s a biofilm factory. Replace it. Every 90 days. No excuses.
And if you’re reading this and you’ve never washed your hands before touching your lenses? Stop reading. Go wash them. Right now. Then come back.
Your eyes don’t have a reset button. Don’t wait until it’s too late.
Shane McGriff
January 28, 2026 AT 23:21I get why people ignore this stuff. I used to. I thought I was invincible. Then I got a tiny scratch from a fingernail, wore my lenses for three days, and woke up with a white spot on my cornea. I thought it was just a pimple. Turns out? It was a bacterial ulcer. I was in the ER at 3 a.m. with a doctor holding a slit lamp like he was about to perform surgery on my soul.
They gave me antibiotic drops every hour. I couldn’t sleep. Couldn’t work. Couldn’t even look at my phone. For two weeks. And that was the mild one.
Now I use dailies. I wash my hands like I’m in an operating room. I throw out my case every three months. I don’t swim with them. I don’t sleep with them. And I don’t feel like a martyr-I feel like someone who still has 20/20 vision at 34.
If you’re reading this and you’re still stretching your lenses? You’re not saving money. You’re gambling with your future. And if you think it won’t happen to you? You’re the exact person it’s going to happen to.
Jacob Cathro
January 30, 2026 AT 13:05Bro. I saw a TikTok about this. Some ophthalmologist said you’re 100x more likely to go blind if you sleep in contacts. So I stopped. Then I checked the CDC site. No such stat. Then I checked the FDA. No mention of "100x." Then I Googled "Cleveland Clinic corneal ulcer stats"-nothing. This is fake science. They just want you to buy new lenses every day. It’s a scam.
Also, I washed my case with tap water for 5 years. Still see fine. You’re all just hyped up.
Paul Barnes
January 31, 2026 AT 14:53The term "corneal ulcer" is correctly used throughout this article. The distinction between abrasion and ulcer is accurately delineated. The risk factors-overnight wear, tap water exposure, poor case hygiene-are empirically supported in peer-reviewed literature. The recommended interventions align with current clinical guidelines from the American Academy of Ophthalmology. No hyperbole detected. No misinformation. This is a model public health communication.
pragya mishra
February 1, 2026 AT 20:19You think this is bad? In India, people wear contacts for months without cleaning them. Some use milk to rinse lenses. Others use saliva. I’ve seen a woman with a ulcer the size of a coin because she wore her lenses while cooking. No doctor. No treatment. Just pain. And silence. You’re lucky you have access to eye clinics. Most of us don’t.
Manoj Kumar Billigunta
February 2, 2026 AT 01:34I’m from a small village in India. We don’t have eye doctors nearby. But I learned this from a visiting nurse: if your eye hurts, take out the lens. If it still hurts, don’t put it back. Wait. Go to the hospital. I told my cousin. She had a white spot. She listened. She went. She saved her eye. This isn’t about fear. It’s about knowing what to do. Simple. Clear. Life-saving.
sagar sanadi
February 2, 2026 AT 03:29So let me get this straight. The government and eye companies want us to believe that sleeping in contacts will blind us, but they’re the same ones selling us the lenses and the solutions. Coincidence? I think not. They make more money if you go blind. Then you need a transplant. Then you need glasses. Then you need surgery. Then you need more drops. It’s a money machine. I’m not buying it.
Thomas Varner
February 3, 2026 AT 12:10Man, I just got a message from my mom. She’s 68, wears glasses, read this whole post, and sent me a screenshot with a note: "You’re 27. You still wear your contacts to bed. I’m not mad. I’m scared. Please stop." I deleted my monthly lenses today. Bought a year’s supply of dailies. I didn’t even think about it. I just did it. Thanks, Mom. And thanks, post.