What Is Herpes Simplex?
Herpes simplex virus (HSV) is a common virus that can affect the skin, mucous membranes, and nerves as well as the eyes. When HSV involves your eye, the cornea is most commonly affected.
Herpes simplex eye disease can have many symptoms, including:
- Decreased vision
- Pain or foreign body sensation of the eye
- Eye redness
- Light sensitivity
- Blisters or ulcers of the eyelids
The symptoms described above may not necessarily mean that you have herpes simplex. However, if you have a history of herpes simplex eye disease or experience one or more of these symptoms, contact your ophthalmologist for a complete exam.
There are two major types of herpes simplex virus (HSV). Type I is the most common and is usually responsible for the familiar "cold sore" or "fever blister," as well as herpes simplex eye disease. Type II is usually responsible for sexually-transmitted herpes. An overwhelming majority of adults have contracted HSV Type I even if they have never had symptoms of infection. The virus lives in nerves and can intermittently activate, causing symptoms.
Herpes simplex eye disease occurs when the virus or a reaction against it occurs in one of the ocular structures. Inflammation and infection at one of the anatomic levels of the cornea is most common. Usually, only one eye is involved (and it can recur), often without typical skin lesions. Spreading the infection to another person is unlikely and sexual transmission of herpes eye disease is extremely rare. The infection varies in duration, severity, and response to treatment, depending on which part of the eye is involved.
The reasons for viral activation are unknown, although stress or illness may be involved.
Tests and Diagnosis
Herpes simplex usually can be diagnosed by a routine exam with a physician. If a HSV rash is present near the eye, or if you have any of the above eye symptoms, you should see your ophthalmologist to rule out viral activity in the eye. Special imaging or other testing is rarely necessary.
Treatment and Drugs
Oral or topical antiviral medications are commonly used to treat herpes simplex eye disease. At times, it may be necessary to scrape the surface of the cornea, to patch the eye, or to use a variety of medications, including steroid eye drops, to control the infection and inflammation. It is important to consult your ophthalmologist before beginning any treatment since some medications may actually worsen the disease. In the case of severe corneal scarring with vision loss, a corneal transplant may offer a chance to improve vision.
Reviewed by Christopher T. Hood, M.D.