Herpes Simplex Eye Infection

What is a Herpes Simplex Eye Infection?

Herpes simplex is a disease caused by the herpes simplex virus (HSV). Type 1 HSV often produces painful, fluid-filled blisters on the skin or other tissues, and it is this form of HSV that causes cold sores and fever blisters.
The other herpes simplex virus, type 2 HSV, mainly affects the genital area and is usually transmitted during sexual intercourse. All of the information below relates to type 1 HSV.

How do herpes simplex eye infections arise?

HSV is very common: about 90% of adults have the infection. Most people are first infected during childhood or early adolescence.

HSV infections affecting the skin or eyes can be triggered by:

• Excessive exposure to sunlight
• Physical or emotional stress
• Fever
• A reaction to certain foods or medicines
• Eye injury
• Sometimes the cause of an infection is unknown.

In some people, HSV eye infections recur frequently. Left untreated, repeated infections can cause serious damage to the cornea (the clear dome at the front of the eye).

What are the symptoms?

Symptoms of an ocular HSV infection include:

• Blisters on or near the eyelid
• Redness
• Irritation
• Watering eyes
• Sensitivity to light
• Blurred vision
• HSV often affects only one eye.

How is the diagnosis made?

Herpes simplex eye infections can be difficult to diagnose, as they can produce the same symptoms as allergies, conjunctivitis, other viruses and reactions to certain medications.

Your ophthalmologist will examine your skin and eyes and ask about your medical history. They may also send a sample of fluid from the blisters to a laboratory for analysis.

How are they treated?

Sometimes herpes simplex eye infections settle without any treatment. In other cases, doctors will prescribe medication for the virus (acyclovir) in the form of eye drops, ointments or oral tablets.

One type of herpes simplex destroys cells within the eye. For this condition, doctors may recommend an additional medicine (corticosteroids) to prevent serious problems. Corticosteroids should not, however, be taken for other forms of HSV. Severe cases can cause scarring and loss of vision, which may require surgery: if the cornea has become severely scarred, the specialist ophthalmologist may recommend keratoplasty (corneal transplantation).

How long do the effects last?

After the first infection, HSV may cause no problems for months or even years. Sores may then reappear when your immune system is weakened by illness or stress. Sometimes HSV is active even though you have no blisters.
The effects of HSV vary greatly from person to person. Your symptoms may subside within a few days or weeks, and you may have only a single episode after the initial childhood infection. Equally, you may have a relapse whenever your immune system is weakened, or for no known reason.

What can I do to prevent herpes simplex ocular infections?

Because herpes simplex virus type 1 is so common, you probably can’t prevent your first infection — many cases are so mild that you may never know you have been exposed to HSV. Later in life, you may be able to help prevent infections by maintaining good general health and keeping the stress in your life at a moderate level.

Are herpes simplex eye infections contagious?

Herpes simplex does not usually spread to the other eye, and passing the virus on to another person is unlikely. If your immune system is extremely weak, the virus can spread to other parts of your body, such as the retina or the brain — but not to another person.