Central Sterile Corneal Ulceration Workup

Updated: Jun 27, 2016
  • Author: Saadia Zohra Farooqui, MBBS; Chief Editor: Hampton Roy, Sr, MD  more...
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Laboratory Studies

Given the morbidity of missing an infectious ulcer, the importance of performing corneal smears and cultures cannot be overemphasized. Infectious etiologies should be ruled out initially by performing smears and cultures. 

Corneal scraping also is indicated to evaluate for infectious etiologies.

Perform a workup to rule out infectious or systemic inflammatory diseases (eg, collagen vascular, autoimmune) as clinically indicated. Systemic testing (eg, blood work) may be necessary in certain patients. 

The precise stains and cultures depend on clinical suspicion, including the following:

  • Stains - Gram stain, Giemsa, Calcofluor white, acid-fast bacillus (AFB), and Gomori
  • Cultures - Sabouraud agar, blood/chocolate agar, thioglycolate solution, and Page solution (then  Escherichia coli overlay)


If clinically indicated, performing a biopsy of the presumed infectious ulcer is recommended to identify the causative organism.