An infection of the eye caused by the type 1 herpes simplex virus (HSV) is known as ocular herpes or more simply as eye herpes. The type that is most common is known as “Epithelial keratitis”. Epithelial keratitis is a recurrent viral infection that affects the cornea (front portion of the eye). This virus can lead to inflammation and scarring of the cornea that often is known as a cold sore on the eye.
Eye herpes is a contagious disease and can be transmitted through close contact with the infected person. This condition is more common in men than in women.
Eye herpes (type-I herpes) can be a cause of concern as it can have uncomfortable symptoms. In a few rare cases, eye herpes can affect deep layers of an infected person’s eye and his/her vision. The infection might be transferred to the eye by touching an active lesion (a cold sore or blister) and then touching your eye.
Different Forms Of Eye Herpes
There are various types of herpes ranging from the ones that cause simple infection to a condition that can possibly cause blindness:
- Herpes Keratitis: It is considered the most common form of eye herpes. It is a form of corneal infection that is viral in nature. This form of ocular herpes generally affects only the top layer, or the epithelium, of the cornea, and mostly heals without scarring.
- Stromal Keratitis: It is a condition in which the infection penetrates into the deeper layers of the cornea. This can cause scarring, vision loss, and sometimes, blindness. Stromal keratitis is evidently caused by a late immune response to the original infection. According to NEI, around 25% of new and recurring cases of eye herpes result in stromal keratitis.
- Iridocyclitis: It can be understood as a serious form of eye herpes in which the iris, as well as the surrounding tissues in the eye, become inflamed, leading to severe sensitivity to light, blurry vision, pain, and redness in the eyes. It is a kind of uveitis that affects the frontal part of the inside of the eye. If the infection is limited to the retina or the inside lining of the back of the eye, then it is called herpes retinitis.
Symptoms of Ocular Herpes
There are several symptoms and signs that are known to be associated with an ocular herpes outbreak. You may witness inflammation of the cornea, that can lead to irritation or sudden and severe ocular pain. Further, the cornea can become cloudy that further leads to blurred vision. The condition is likely to be herpes if your doctor finds some or all of these symptoms:
- Swelling in the area around the eyes.
- A feeling of something being there in the eye
- Frequent headaches
- Tearing of the eye
- Recurring eye infections
- Sensitivity to light
- Irritation in and around the eye
Due to this wide range of symptoms, your optician may overlook an early diagnosis of ocular herpes in it’s very initial stages. Experiencing herpes sores on the top of the eyelids is normal. These may appear as a rash with blisters. Crusts are formed by the blister that usually heals within 3-7 days. In case the herpes virus affects the cornea, the retina, or the inside of the eye, a person might witness reduced vision. Even if a person’s eye might appear painful, eye herpes does not cause a lot of pain.
The symptoms shown by the HSV infection that affects the eye might be very similar to those of the varicella-zoster virus, which causes chickenpox. But a varicella-zoster infection is expected to result in a rash with a distinct pattern that occurs in only one eye. Pinkeye or conjunctivitis is another condition that can have similar symptoms.
Causes of Eye Herpes
The herpes is likely to spread via nasal secretion of a person or spit of a person containing the infected. It is more prone to be spread if the infected person has a cold sore. The virus within the secretion can travel through the person’s nerves including the eye nerves.
In a few cases, the virus does not lead to any symptoms or problems after entering the body. This form of the virus is described by the doctors as lying dormant.
The exact cause of the outbreak is unknown, however, some specific triggers may sometimes lead to a dormant virus to begin reproducing and cause eye irritation. Following are the examples of these triggers:
- A major surgical and dental procedure
- Trauma or severe injury
Eye herpes may prove highly contagious. But not everyone will catch the eye herpes virus when coming in contact with the infected person.
Diagnosing of Eye Herpes
Ophthalmologists, or eye doctors, generally diagnose herpetic eye disease/disorder by examining the person’s medical history and questioning them about their symptoms. They ask the patient about when did they first observe the symptoms and what makes them worse or better.
The ophthalmologist can further conduct a physical examination of the eye. This examination will involve the use of a special microscope known as a slit lamp to comprehend the eye’s surface and, potentially, the eyelid.
These professionals generally, will diagnose eye herpes by just looking at the sores. In case the infection has penetrated into deeper layers of the eye, then they will be needing to use special instruments to measure the eye pressure. They will also inspect the deeper eye layers.
As a part of the diagnosis, the doctor may collect a small cell sample known as a culture from the blistered area. This sample then would be sent to a lab for testing for the presence of HSV.
Although there is no complete cure for herpes, there are some things that you can do to control it spread and prevent recurring outbreaks:
- Avoid touching your eyes
- Steroids can aggravate the herpes virus in the body. You should not be putting on steroid eye drops unless you are having an anti-viral medicine as well.
- Avoid wearing contact lenses if you notice recurring infections.
- Visit an ophthalmologist immediately, in case symptoms of ocular herpes return.
The best way to treat your eyes is to visit your eye care professional and get your eyes checked regularly. He will be able to assess the best method of treatment for your eye ailment.
Eye Herpes vs Conjunctivitis
Anyone can mistake eye herpes for conjunctivitis, which is more commonly referred to as pink eye. Both of the conditions might be caused by a virus, though conjunctivitis may also be caused by:
Your doctor can make an accurate diagnosis using a culture sample. In case you have eye herpes, the culture will test positive for type 1 HSV (HSV-1). A correct diagnosis can help you to receive proper treatment and eliminate the disease at the earliest.
Treatment Procedure For Ocular Herpes
If your eye specialist has detected the presence of eye herpes, then he will start prescribing anti-viral medications to you. But the treatment methods can differ. As both epithelial keratitis and stromal keratitis, have different types of treatment methods.
Treatment For Epithelial Keratitis
In most cases, the HSV infection present on the outside surface of the cornea goes away within a few weeks. And regular intake of antiviral medicines will minimize the chances of vision loss and any kind of corneal damage. The eye specialist can prescribe certain antiviral eye drops/ointment/pharmaceutical drugs which are antiviral in nature.
Your eye specialist can also use the procedure known as “debridement” for the treatment.
Treatment of “Stromal Keratitis”
The treatment procedure for this medical condition includes antiviral medicinal therapy. But your eye specialist can also prescribe intake of some steroid (Anti-inflammatory) eye drops, to lower the swelling level in the “Stroma” section.
Is “Eye Herpes” A Recurring Medical Condition?
Around 20% of people who have suffered from eye herpes are more than like to suffer again from this medical condition. But in case the instances of outbreaks become multiple, then your eye specialist can recommend a daily intake of “Antiviral medications”.
And when the outbreaks are more than one in number, then there can be severe complications. These complications include:-
- You become more than susceptible to develop ulcers.
- Your corneal surface may start to become numb.
- There may be perforation of the cornea.
Eye herpes is not curable. But you can minimize the damage inflicted to your eyesight during outbreaks. Go and consult your eye doctor as soon as you figure out the condition. The sooner you get the treatment for eye herpes, the lesser will be the damage to your cornea.
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