Final answer:
Immediate cessation of contact lens wear and urgent referral to an ophthalmologist are required for the management of a corneal ulcer with severe symptoms to prevent potential complications such as vision loss or blindness.
Step-by-step explanation:
The management of a corneal ulcer with feathery margins and associated symptoms after overnight contact lens use should begin with the cessation of contact lens wear and the initiation of urgent ophthalmologic evaluation. This will likely lead to empirical antimicrobial treatment pending laboratory diagnostic results. Gram stain, cultures, or PCR may be utilized for definitive pathogen identification.
Prompt referral to an ophthalmologist for immediate assessment and treatment is critical, as conditions such as bacterial keratitis or Acanthamoeba keratitis can progress rapidly and have severe consequences, including vision loss or blindness. Contact lens wearers are particularly susceptible to infections due to bacteria such as Pseudomonas aeruginosa or fungi, which can become trapped between the lens and the corneal surface.
Because the described symptoms and presentation are severe, including hypopyon, the patient requires immediate intervention to prevent further complications. Antibiotics or antivirals may be prescribed based on the organism identified, and in some cases, corticosteroids or other treatment modalities may be indicated.