Eye & Herpes

Each year in the US there are approximately 25 million people who suffer from flare ups of facial herpes and there are about 500,000 people in the US with a history of herpetic eye disease.

Herpes is commonly thought of as a sexually transmitted disease but HSV-1 (the virus responsible for oral sores, cold sores and fever blisters), is easily transmitted through casual contact.  In fact a recent study showed that 98% of the healthy population in the US most likely shed the HSV-1 virus through their blood, tears or saliva even if they didn’t have or had never had an open lesion.

When there is involvement of the eye & herpes simplex it usually occurs only on one side and most often involves the cornea.  This type of corneal infection is called Herpes Keratitis.

This eye & herpes infection can be superficial or it can involve deeper layers of the cornea.  When the infection is deeper it can leave scar tissue, loss of fields of vision or even blindness. Herpes eye infections are actually the most common cause of infectious blindness in the US each year.

Less commonly the infection will involve the inside structures of the eye or the retina.  People find that they experience blurred vision, sensitivity to light and pain and redness of the eye. After reactivation the virus can travel down the nerves in the face and land in the eye.  The factors that determine if the infection will be only in the skin or will also infect the eye aren’t known.

Unlike the skin infections that appear to decrease in intensity and frequency with recurrences eye & herpes infections can become more frequent.  After the first episode of corneal infection one in four people will have another infection in the next two years – and then the odds of recurrences after that increase greatly.

The treatment of eye & herpes infections will depend upon the location and depth of the infection.  People who suffer from a superficial infection, which will heal without scarring, will require only antiviral ophthalmic ointments or drops to treat the infection.

Other ophthalmologists may also use a dry cotton tipped applicator to remove infected cells from the cornea to help speed healing.  This process is called debridement.  After this process a soft contact lens might be prescribed to cover the cornea while it heals.

If the infection is deeper ophthalmologists find that the antiviral eyedrops currently available aren’t effective.  Steroids drops may be used to help decrease the inflammation and prevent some corneal scarring.  However, there are some patients who don’t respond well to available treatments and may have prolonged infections that result in permanent scarring and blindness.

Several organizations, including the National Institute for Allergies and Infectious Diseases, have awarded funding to further evaluate the transmission, growth and potential treatment methodologies to improve treatments and reduce the number of people who suffer the devastating consequences of this condition.

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