leading to vision loss or permanent eye damage. It is crucial to treat these ulcers as emergencies in the following situations:

• Severe Pain and Discomfort: If the pain in the eye becomes unbearable, it could indicate a deep infection or an ulcer that is worsening.
• Sudden Vision Changes: Any sudden decrease in vision or blurring, especially if it progresses quickly, is a critical sign that the ulcer is impacting the deeper layers of the cornea or leading to complications.
• Increasing Redness: An increase in redness around the eye or within the eye itself suggests spreading inflammation.
• Light Sensitivity: Intense sensitivity to light, causing significant discomfort or making it difficult to open the eye, can be a sign of a severe ulcer.
• Visible Infiltrates: If you can see white or grey spots on the cornea or it appears cloudy, it's essential to seek immediate medical help.
• Unresponsive to Initial Treatment: If symptoms do not improve or worsen after starting treatment, urgent reassessment and possibly more aggressive treatment are necessary.

These symptoms indicate that the corneal ulcer is at a stage where without immediate and effective treatment, the risk of long-term damage increases significantly. Prompt intervention by an eye care specialist is crucial to manage the condition effectively and preserve vision

The most common causes of corneal ulcers are:

• Bacterial infections, often related to improper use of contact lenses, such as sleeping in contacts not designed for overnight wear or inadequate disinfection of lenses.
• Viral infections, including the herpes simplex virus (commonly causes cold sores) and the varicella-zoster virus (known for causing chickenpox and shingles).
• Fungal infections, which can occur after the cornea is damaged by an injury involving plant material, or in an agricultural setting.
• Parasitic infections, such as Acanthamoeba keratitis, particularly in contact lens wearers who are exposed to water.

Each type of infection can lead to different types and severities of corneal ulcers, characterized by their cause and the specific pathogens involved.

Polymicrobial infections are increasingly recognized in cases of keratitis, with approximately 43% of cases involving multiple microorganisms. These infections can complicate diagnosis and treatment, as they involve various types of bacteria, fungi, and sometimes protozoa co-inhabiting the same cornea. Accurate microbial identification through culturing is crucial in such scenarios to ensure appropriate and effective treatment is administered.