Herpes Simplex Eye Infection
Herpes simplex virus (HSV) is a common virus that can affect the skin and areas inside the body involving nerves and mucous membranes. Genital herpes, for example, is a sexually transmitted disease caused by the Type II herpes simplex virus (HSV).
The most common type of herpes simplex virus is Type I. Infections of Type I HSV are often seen as a cold sore or fever blister in the mouth, on the face or the upper body. Most people, upwards of 90%, have had a Type I HSV infection during their lifetime, usually during childhood or early adolescence.
The herpes simplex virus can invade tissues and then remain dormant for months or years following the initial infection. The infection can again result in a sore or lesion when the patient is under physical or emotional stress.
How Does Herpes Simplex Virus Affect The Eye?
The eye is a very common site for Type I herpes simplex virus infections. The infection may begin as an inflammation of the conjunctiva (the soft, outer lining of the eye). In most eye infections, HSV affects the cornea. It may cause ulcers on the surface of the cornea. These ulcers may develop tiny branches or dendrites. Sometimes, fever blisters or vesicles may appear on the eyelid. In some instances, the eye may turn red and become extremely sensitive to light.
Most people will have one episode of Type I HSV infection during their lifetime. About 25% will have a recurrence of the infection within two years of the initial infection.
Herpes simplex virus is typically unilateral, affecting only one eye. The infection usually resolves within a few days or weeks on its own.
Are Herpes Simplex Virus Infections Serious?
Each case of herpes simplex virus is different. Some infections are very simple and uncomplicated, resolving on their own in a matter of a few days or weeks. Other cases may be quite severe.
Severe episodes of HSV infection may result in permanent damage to the eye if untreated. The infection can invade the cornea or inner structures of the eye.
HSV infections may also become chronic. Frequent outbreaks of the HSV infection increase the possibility of damage to the eye. In cases where the individual’s immune system is weakened, the HSV infections may become more frequent, last longer, and be more difficult to cure.
Are Herpes Simplex Virus Infections of the Eye Contagious?
Type I Herpes simplex virus infections involving the eye is typically not contagious. They usually do not even spread to the fellow eye. Transmitting the virus to another person is highly unlikely. When the person’s immune system is weakened, the virus may spread to other parts of the body.
Type II herpes simplex virus infections; on the other hand, are classified as a sexually transmitted disease. These infections are quite contagious.
How Are Herpes Simplex Virus Infections Treated?
A wide variety of antiviral medications in the form of eye drops or ointments and other therapies are available for the treatment of herpes simplex eye infections. The antiviral medications attempt to destroy the virus. It is important to adhere to the treatment schedule to obtain the best results. Caution must be taken when using these medications, for they may cause symptoms more severe than the herpes simplex virus infection they are intended to treat. Close supervision by a doctor is essential when using antiviral medications.
Other forms of treatment may include debridement, in which the surgeon simply scrapes away the lesion with a cotton swab. Patching of the eye or wearing a soft contact lens after debridement is also found to be effective in relieving the symptoms until the infection abates. Steroids may also be used in selected cases.
Severe infections of the herpes simplex virus may cause scarring of the cornea. In these cases, a corneal transplant may be indicated. Excimer laser PTK is contraindicated in patients with corneal scarring secondary to HSV Type I. Studies have shown that the excimer laser energy source can cause recurrences of the herpes simplex virus.