HSV is very common. About 90% of adults have had the infection. HSV is spread through contact with fluid from a person’s mouth. Most people have their first infection during childhood or early adolescence. Show
Attacks of HSV that affect your skin or eyes can be triggered by:
Sometimes the cause of attacks is unknown. In some people, HSV eye infections recur often. If not treated, repeated infections can cause serious damage to the cornea (the clear dome on the front of the eye). HSV symptomsThe symptoms of HSV eye infections are:
HSV often affects only one eye. How are they diagnosed?Herpes simplex eye infections can be difficult to diagnose. They may cause the same symptoms as allergies, other viruses, and reactions to some medicines. Your doctor will examine your skin and eyes and ask about your medical history. Your doctor may send some of the fluid from the blisters to a lab for analysis.
How Kirk Eye Center treats HSVSometimes herpes simplex eye infections go away without any treatment. Other times your doctor will prescribe medicines in the form of eye drops or ointments to kill the virus. To help speed up healing, your eye doctor may scrape the blisters away with a cotton swab. If your eyes do not get better with these treatments, you may need to take medicine in pill form. One type of herpes simplex destroys cells in the eyes. For this condition your eye doctor may recommend that you take an additional medicine (corticosteroids) to help prevent serious problems. However, corticosteroids should not be taken for other forms of HSV. Be sure that your eye doctor knows about all your symptoms. Severe cases may require surgery. Some doctors recommend keratoplasty (a cornea transplant) if the cornea has been severely scarred. They may prescribe pills to reduce the chance of HSV in the transplant. How long do the effects last?After the first infection, HSV may not cause any problems for months or years. Then sores may reappear when your immune system is weakened by disease or stress. Sometimes HSV is active but you do not have any blisters. The effects of HSV vary greatly from person to person. Your symptoms may go away in a few days or weeks. You may have only one attack after your initial infection in childhood. However, you may have a recurrence whenever your immune system is weakened or for unknown reasons. What you can do to help prevent herpes simplex eye infectionsBecause type 1 herpes simplex virus is so common, you probably cannot prevent your first infection. Many cases are so mild that you may not know you have been exposed to HSV. Later in life, you may be able to prevent attacks by maintaining general good health and keeping stress in your life at a moderate level. Sometimes attacks occur for no known reason and probably cannot be prevented. Are herpes simplex eye infections contagious?Herpes simplex usually doesn’t spread to the other eye, and spreading the virus to another person is unlikely. If you have an extremely weak immune system, the virus may spread to other parts of your body such as the retina or the brain, but not to another person. Schedule a consultation in Loveland, CO todayIf you believe you are in need of treatment for Herpes Simplex Eye infections, seek our help now! For more information about these and other eye health topics, including disorders, diagnosis, treatment and more, please contact Kirk Eye Center using the form on this page or call us at 970-408-3246 today. Our Loveland practice serves patients throughout Northern Colorado, including Fort Collins, Windsor and other nearby areas. Eye herpes, also known as ocular herpes or herpes simplex keratitis, is an eye infection caused by the herpes simplex virus (HSV). Approximately 24,000 new cases of eye herpes are diagnosed in the United States each year, and an estimated 1 million new cases per year are diagnosed globally. Men are slightly more likely to get eye herpes than women. The area of the eye affected depends on the type of eye herpes. Usually, the cornea (the normally clear dome that covers the front part of the eye) is affected, but eye herpes can reach the inside of the eye or the retina (the thin layer of tissue that lines the back of the eye on the inside). Eye herpes can also cause inflammation of the eyelids, the conjunctiva (the clear tissue covering the white part of the eye and the inside of the eyelids), or the iris (the colored part of the eye that controls the amount of light entering the eye). Eye herpes cannot be cured, but it can be managed. Portra / Getty Images Types of Eye HerpesThere are two main types of eye herpes. Epithelial keratitis is the more common form of eye herpes, but stromal keratitis is more serious and can lead to blindness. Epithelial KeratitisEpithelial keratitis accounts for an estimated 50%–80% of all ocular herpes infections. HSV epithelial keratitis affects the outermost layer of the cornea called the epithelium. The virus destroys corneal epithelial cells as it replicates. Stromal KeratitisStromal keratitis affects the deeper layers of the cornea called the stroma. It is caused by a combination of viral infection and compromised immune mechanisms. Stromal keratitis can result in corneal scarring and loss of vision. There are two types of stromal keratitis: stromal keratitis without ulceration and HSV stromal keratitis with ulceration. Stromal keratitis without ulceration:
HSV stromal keratitis with ulceration:
Herpes Zoster OphthalmicusThe herpes zoster virus (which causes chickenpox and shingles) can also cause eye herpes. Like the herpes simplex virus, the herpes zoster virus stays dormant in the body once contracted, and you can have flare-ups, periods of reactivation and worsening symptoms. Symptoms of herpes zoster ophthalmicus are similar to HSV eye infections but can also include:
Eye Herpes SymptomsSymptoms of eye herpes include:
Eye Herpes vs. Pink EyeSymptoms such as redness, pain, eyelid swelling, or discharge from the eye can occur with both eye herpes and pink eye (conjunctivitis), so eye herpes is sometimes mistaken for pink eye. Pink eye can be caused by a bacterial infection, a viral infection, allergies, or chemical exposure, while eye herpes is always caused by a virus. Pink eye can affect one or both eyes. While it is possible for eye herpes to occur in both eyes, it usually appears in just one eye. If the infection recurs within a year, it's more likely to be viral rather than bacterial, or it may be from chemical exposure. Because the symptoms for eye herpes and pink eye are similar and both can be caused by a virus, it is important to see a healthcare professional to get a proper diagnosis. Doing so will ensure the most effective treatment for either condition. Healthcare professionals usually make a diagnosis of pink eye without doing a viral or bacterial culture. Occasionally, this leads to a missed eye-herpes diagnosis. If you have been diagnosed with pink eye, but it doesn't seem to be clearing up with or without treatment, book a follow-up with your healthcare professional to rule out eye herpes. CausesEye herpes is caused by the herpes simplex virus (HSV). While there are two forms of HSV that can cause eye herpes, it is usually caused by HSV-1, the same virus that causes oral herpes (cold sores or fever blisters). While HSV-1 can be transmitted directly to the eye such as by touching a cold sore on the mouth and then touching the eye, eye herpes is often the result of a flare-up of an earlier HSV-1 infection in another part of the body (usually the mouth.) HSV-1 is very common. Approximately 3.7 billion people under age 50 worldwide have HSV-1 infection. Seropositivity (antibodies found in the blood for a particular infection) for HSV-1 has been reported in 65% of Americans. Most people in the United States will contract HSV-1, usually in childhood. Many people are unaware they carry the virus and it can remain dormant (inactive and asymptomatic) in the body indefinitely. A flare-up, or breakout, can occur if the virus starts to multiply or moves from one area of the body to another. Flare-ups can be random, or they can be triggered by:
HSV is typically infectious during the five to 10 days the skin lesions are healing, as well as during asymptomatic shedding in saliva. Unlike genital herpes, eye herpes is not sexually transmitted. There are some key differences between HSV-1 and HSV-2: HSV-1
HSV-2
DiagnosisEye herpes is usually diagnosed by eye specialists called ophthalmologists or optometrists. The eye specialist will take a health history and have a discussion of symptoms, including the items in the lists that follow. Ocular symptoms:
Contact lens history:
Review of other ocular and medical history:
The eye-care specialist will also perform an eye exam that includes checking for light sensitivity, vision, and general health. Diagnostic tests and procedures the eye specialist may use include:
TreatmentThe treatment for eye herpes depends on the type, location, and severity of the infection. Epithelial KeratitisEpithelial keratitis usually responds well to treatment and has no lasting major complications. Treatment for epithelial keratitis may include: Topical Antivirals The most common topical antiviral agents for treating epithelial keratitis include:
Zirgan is often the first choice of topical treatment. While Viroptic is effective, it is known to be toxic, which can delay corneal healing. Oral Antiviral Medications Oral antiviral medications used to treat dendritic epithelial keratitis include:
Geographic epithelial keratitis, another subset of epithelial keratitis, may require higher doses and a longer treatment period. Oral antivirals are less expensive and have a more manageable dosing schedule than topical antivirals, so they are often a first-choice treatment. Oral antivirals should be used with caution in patients with kidney or liver disease. Corneal Epithelial Debridement This treatment involves wiping infected cells off the cornea with a dry, cotton-tipped applicator. Debridement removes approximately 90% of the virus in the eye. It can be combined with antiviral treatment. Stromal KeratitisStromal keratitis is generally treated with oral antivirals along with topical steroids. Topical steroids reduce the inflammation caused by the immune response to the dead viral particles and help prevent corneal scarring. However, they can reactivate the epithelial disease. Taking oral antivirals along with topical steroids helps prevent this reactivation. PrognosisEye herpes does not currently have a cure, but it can usually be managed without long-term complications. Eye herpes usually clears up with treatment in about one to three weeks. Symptoms may improve before the end of the prescribed treatment, but it is important to finish your treatment plan as outlined by your doctor. If symptoms do not improve with treatment within two weeks, book a follow-up appointment. The recurrence of ocular herpes is a concern. Those who have recurrent issues of live virus (such as with epithelial keratitis) may need to take long-term oral antivirals proactively. People who have recurrent stromal keratitis may need to take long-term steroid drops with either oral or topical antivirals. If the eye herpes infection goes untreated or doesn't respond to treatment, serious complications can occur such as:
The earlier treatment is started, the less risk there is for serious complications. Is There a Vaccine for Eye Herpes?While there is not currently a vaccine to prevent eye herpes, studies are being conducted into one. You can help reduce the risk of transmission by:
SummaryEye herpes is caused by infection with the herpes simplex virus, with symptoms of redness, pain, and swollen eyelids. Epithelial keratitis is the more common type, but stromal keratitis is more serious because it can lead to blindness. It is treated with topical and oral antiviral medications, depending on the type and severity. A Word From VerywellWhile eye herpes can't be cured, outbreaks can be managed, and well-managed outbreaks reduce the risk of damage to the eye. Recurrent outbreaks can often be prevented by taking preventive measures, such as long-term antiviral medication. If you have symptoms of eye herpes—even if you think it may just be pink eye—see your healthcare professional or eye-care specialist for a proper diagnosis and treatment plan. A doctor can prescribe the necessary medications to help heal you. Is Eye Herpes an STD?Unlike a separate virus that causes genital herpes, herpetic eye disease is not sexually transmitted. One of the viruses that causes herpetic eye disease is called the varicella-zoster virus.
Is herpes of the eye contagious?Are herpes simplex eye infections contagious? Herpes simplex usually doesn't spread to the other eye, and spreading the virus to another person is unlikely. If you have an extremely weak immune system, the virus may spread to other parts of your body such as the retina or the brain, but not to another person.
Is there a cure for herpes in the eye?Ocular herpes can produce sores on the eyelid or surface of the cornea. Recurrences can lead to complications like blindness or meningoencephalitis, a lethal infection of the brain. There's no cure for ocular herpes, but it can be controlled with antiviral drugs.
How do you know if herpes is in your eye?If the virus multiplies and becomes active, herpes eye disease symptoms may occur. These include eye redness, tearing, and even vision loss. These affected areas can become damaged.
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