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EYE HERPES

Men's Health, Women's Health / By

EYE HERPES

Eye herpes is a common, potentially serious viral infection affecting the eyes.

  • Eye herpes is the most common source of infectious blindness in the Western world
  • There are several forms of eye herpes, ranging from a simple infection to a condition that can possibly cause blindness. They include:
  • Epithelial keratitis affects only the thin, outermost layer of the cornea, known as the epithelium, and usually heals without scarring. This is the most common form of eye herpes
  • Stromal keratitis occurs when the infection goes deeper into the layers of the cornea. Stromal keratitis is thought to occur as a result of antibody responses against the viral antigen in the stroma, triggering a massive immune response in the eye. The response may result in the destruction of the corneal stroma, resulting in loss of vision. According to the National Eye Institute (NEI), about 25% of recurring cases of eye herpes infection result in stromal keratitis
  • Eye herpes also referred to as ocular herpes is mostly unilateral, affecting one eye at a time
  • According to the National Eye Institute (NEI), untreated eye herpes has a 40-50% rate of returning.
  • The recurrence rate of eye herpes disease after an initial infection is 27% at one year, 50% at five years, and 63% at 20 years. The risk increases with the number of recurrences.

CAUSES

Eye herpes is caused by the herpes simplex virus (HSV).

Once infected with HSV, it can’t be completely eradicated from the host. it often lays dormant in the nerve cells and can travel along the nerve cells of the eye when reactivated.

The virus may reactive in response to certain stressors, including exposure to ultraviolet light, hormonal fluctuation, and psychological stress.

Most people have been infected with the virus at some point in their lives, but not everyone gets symptoms from the virus

There are two major types of herpes simplex virus:

  • Type 1 virus (HSV-1) which commonly affects the face and is responsible for symptoms including cold sores or fever blisters. Most often, a person will be infected by direct contact with the skin of a person with active HSV-1.
  • Type 2 virus (HSV-2) is the sexually transmitted form of the virus. This is usually associated with genital herpes, but it can also affect the eyes

The majority of eye herpes infections are caused by HSV-1, except in cases of neonatal eye infections, which are largely caused by HSV-2 contracted through an infected birth canal.

SYMPTOMS

Symptoms usually depend on what part of the eye is affected. They may include:

  • Headache
  • Swelling around the eyes
  • Tearing
  • Irritation
  • Sensitivity to light
  • Watery eye discharge
  • Eyesores
  • Eye redness
  • Blurred vision

DIAGNOSIS AND TREATMENT

To make a diagnosis, the doctor will ask detailed questions about your symptoms, including when they started and whether you have had a previous episode of similar symptoms

The doctor will perform a thorough eye exam to evaluate your vision, eye movements, and sensitivity to light.

To widen your iris and to enable a clear view of your retina in the back of your eyes, the doctor will put eye drops in your eyes.

The doctor may perform a fluorescein eye stain test. During this test, an eye drop is used to place a dark orange dye (fluorescein) onto the outer surface of your eye.  The way the dye stains your eye will help in identifying any problems with your cornea, such as scarring from HSV infection

A sample of cells from your eye surface can also be ordered to check for HSV.

TREATMENT

Early diagnosis may result in early treatment, and this may improve your outlook.

For epithelial keratitis, promptly taking oral antiviral medication can help minimize cornea damage and vision loss. The doctor may also recommend eye drops or ointment.

A common treatment is the oral medication acyclovir (Zovirax)

For stromal keratitis, steroid (anti-inflammatory) eye drop is taken in addition to antiviral oral medications.