Can Herpes Affect the Eyes?

by Mar 6, 2019

Type 1 herpes simplex virus (HSV) is a common condition that can cause cold sores around the mouth and lips, and can also lead to infection of the eye.  Usually, when HSV1 infects the ocular region, it affects the front surface of the eye (the cornea) and has the potential to result in permanent damage and scarring.  It’s important to point out that Type 1 HSV is different and distinct from Type 2 HSV, which more commonly infects the genitals and is transmitted as an STD.

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Causes of Ocular Herpes Infections

It’s estimated that over half of the population has been exposed to type 1 herpes simplex virus.  HSV1 can be transmitted by contact with others who are having an active outbreak, such as a cold sore.  Once infected, the virus typically lays dormant in a bundle of nerves within the body for long periods of time.  In many cases, the virus lays dormant in the body for years, or may never “wake up.” Outbreaks of the virus, in which the virus is disrupted from its resting place and begins actively infecting the body, may occur sporadically. Though the exact cause of outbreaks is unknown, it is believed that stress, trauma, sun-exposure, or other concurrent infections may play a role in triggering an outbreak.  

 

When the Eye Becomes Involved

There are several ways in which HSV1 can affect the eyes, and severity depends on the type or location of infection.  Most commonly, ocular outbreaks of HSV1 result in “epithelial keratitis,” which means the infection is localized in the outermost layer of the cornea.  The virus can also cause an inflammatory reaction within deeper levels of the cornea, in which case the outbreak is called “stromal keratitis.” Stromal keratitis is a more serious condition; there is a potential for corneal scarring, which cause permanent visual changes.  Epithelial keratitis can develop into the more serious stromal keratitis if it is left untreated. More rarely, herpetic uveitis can occur, which is a condition causing inflammation of the iris and other tissue around and inside the eye, leading to severe discomfort.

 

Symptoms, Diagnosis, and Treatment of Herpes Simplex Keratitis

When an ocular infection of HSV strikes, the symptoms can masquerade as a series of eye injuries or infections.  Common symptoms include pain, redness, light sensitivity, watery discharge, and a foreign body sensation. To diagnose ocular herpes, the optometrist will closely evaluate the front of the eye using a microscope and look for characteristic signs of herpes simplex keratitis.  Superficial lesions on the front surface of the eye, or swelling of the central layers of the cornea, can indicate that an outbreak has occurred. If diagnosed, they will prescribe antiviral eye drops or oral medications to prevent the worsening of the condition. The doctor will also require frequent follow-up visits to ensure the ocular surface is properly healing and that all steps are being taken to prevent permanent vision loss.  For those who have experienced recurrent ocular herpes outbreaks, the doctor may suggest a preventative dose of an oral antiviral medication to be taken every day, which may deter future outbreaks of the condition.

 

If you have experienced ocular irritation that think you may have a herpes infection in the eye, our optometrists at Neal Eye Group are here to help!  Call us at (610) 828-9701 or schedule your appointment online for an eye exam with the Neal Eye Group.  We serve Norristown, King of Prussia, Philadelphia, and East Norriton.

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