Eye Herpes: Keratitis Symptoms & Emergency Care

Eye herpes, also known as ocular herpes, is a viral infection of the eye caused by the herpes simplex virus (HSV). It can affect various parts of the eye, most commonly the cornea, leading to a condition called herpes keratitis. This infection is a leading cause of corneal blindness worldwide, making early recognition and treatment crucial. In this article, we explore the symptoms, risk factors, and emergency care for herpes eye infection, including herpes keratitis and general herpes in the eye.

What is Eye Herpes?

Eye herpes, or ocular herpes, is typically caused by herpes simplex virus type 1 (HSV-1), the same virus that causes cold sores. While HSV-2 (genital herpes) can also cause eye infections, it is less common. The virus can infect the eyelids, conjunctiva, iris, and cornea. The most common manifestation is herpes keratitis, an inflammation of the cornea. Once infected, the virus remains dormant in the body and can reactivate, leading to recurrent episodes. Understanding the nature of herpes in the eye is essential for effective management.

Transmission occurs through direct contact with infected saliva or lesions. For example, if someone with an active cold sore touches their eye, they can introduce the virus. The initial infection may go unnoticed, but subsequent reactivations can cause significant symptoms. Risk factors for reactivation include stress, fever, sunburn, eye injury, or immunosuppression.

Symptoms of Herpes Keratitis

The symptoms of herpes keratitis can vary depending on the depth of corneal involvement. Common signs include:

• Eye redness and irritation
• Pain or aching in the eye
• Blurred vision or sensitivity to light (photophobia)
• Excessive tearing or discharge
• Sensation of a foreign body in the eye
• Swelling of the eyelids

In some cases, a characteristic dendritic (branching) ulcer may appear on the cornea, visible only with a slit-lamp exam. If you experience any of these symptoms, especially if you have a history of cold sores or previous herpes eye infection, seek medical attention promptly. Delay can lead to scarring and vision loss.

Diagnosis and Treatment

Diagnosis of herpes keratitis is typically made by an ophthalmologist through a slit-lamp examination. The doctor may apply a fluorescent dye to highlight corneal ulcers. In some cases, a swab may be taken to confirm the virus. Early diagnosis is key to effective treatment.

Treatment involves antiviral medications, usually in the form of eye drops (e.g., trifluridine, ganciclovir) or oral antivirals (e.g., acyclovir, valacyclovir). For superficial infections, topical drops are sufficient. Deeper infections or those with significant inflammation may require oral medication and close monitoring. Steroid eye drops are sometimes used to control inflammation but must be used cautiously as they can worsen the infection if used alone.

Prevention and Long-Term Management

For individuals prone to recurrent eye herpes, preventive measures can reduce outbreaks. These include managing stress, using sunscreen on the face (since UV exposure can trigger reactivation), and avoiding touching the eyes during an active cold sore. Some patients may be prescribed long-term oral antiviral therapy to suppress recurrences.

If you have had a herpes eye infection before, inform your eye doctor about your history. Regular eye exams can help monitor for early signs of recurrence. In severe cases, corneal transplantation may be needed if scarring impairs vision, but this is a last resort.

Remember, herpes in the eye is a serious condition, but with prompt and appropriate care, most people recover without long-term vision loss. If you suspect you have symptoms of herpes keratitis, do not delay seeking medical attention. Your vision depends on it.