It may sound odd to discuss herpes virus in the context of the eye, but herpes simplex eye infection is actually extremely common. It is the leading cause of infectious corneal blindness in the developed world and is routinely seen in the offices of eye doctors everywhere.
Almost everyone harbours the subtype of herpes simplex virus that causes eye infections from their childhood. Read on to learn more about this condition and how it is treated.
Where Herpes Simplex comes from
After initial infection in childhood, the herpes simplex virus lays dormant in the body throughout one’s entire lifetime. It is the same virus that arises to cause cold sores every once in a while.
Recurrence of the condition, whether in cold sores or eye trouble, usually results from stress, ultraviolet light exposure, illness, hormone changes, or immunodeficiency. This can happen repeatedly throughout life and affect the face or the eyes.
How we diagnose Herpes Keratitis
If you are experiencing reduced vision, a feeling of something in your eye, or intense ocular pain, you might come in and see our optometrist. They will check your vision, ask about recent changes in health or medications, and check your eyes with the microscope.
Herpes simplex has great variability in how it affects the eyes. It can cause painful vesicles on the eyelids, pinkeye, and infect the cornea and deeper structures.
A herpes simplex corneal infection is the most likely herpetic infection to bring you into our office. It can range from looking like a minor scratch on the cornea to causing massive corneal melting and swelling that spreads inflammation and pain to all adjacent structures inside the eye.
Our doctor will likely instill some fluorescein dye that enables them to get a better look at the extent of the corneal lesion. They might also test how sensitive your corneas are by very lightly touching them with cotton wool.
To rule out more severe variants of the disease, the pressure inside your eyes will be measured and pictures of the back of your eyes might be taken as well. If herpes invades the retina, perhaps in someone who is immunocompromised, rapid tissue destruction and vision loss can occur.
How do you treat Herpes Simplex keratitis?
The primary treatment for herpes simplex virus is antivirals, either as topical eye drops or as capsules to be swallowed. You must follow medication instructions exactly to ensure proper recovery.
Artificial tears might also be prescribed to help your eye heal more quickly. If the infection is severe, other eye drop medications like steroids might be needed to control the amount of inflammation in the eye.
Even after the initial infection is resolved, there can be long term reduction in vision if corneal scarring occurred. This is the main reason why, in severe infections, a large reduction in vision is possible.
The infection can also cause a lack of corneal sensitivity which impacts its ability to heal and protect itself. If this is the case, our optometrist will use drops and many other methods to make sure your corneas heal properly.