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Herpes eye infections

As well as affecting the skin, herpes viruses can also infect the eyes, causing inflammation, redness, pain and light sensitivity.

A herpes simplex virus infection of the eye is a risk to a person's sight, but is not usually serious as long as treatment starts early.

Herpes eye infections are relatively common in middle age and affect up to around one in 500 people in the UK.

How does herpetic eye disease develop?

Like many viruses, the herpes simplex and varicella-zoster viruses are present in most adults. The viruses in the herpes family usually live around the nerve fibres in humans without ever causing a problem. Occasionally, the viruses will start to multiply, or they will move from one area of the body to another, and that is when herpetic disease breaks out. This often happens when the immune system of the body is weakened by another health problem. It is also possible to infect the eye if a person touches a cold sore, for example, and then touches their eye without washing their hands first.

How is herpetic eye disease diagnosed?

The two types of herpetic eye disease have different symptoms. One thing they have in common, however, is that they can both be very painful because they affect the nerves directly. The problem is likely to be herpes zoster ophthalmicus if your eye doctor finds some or all of these symptoms:

  • Pain in and around only one eye
  • Redness, rash, or sores on the eyelids and around the eyes, especially on the forehead. Sometimes the rash breaks out on the tip of the nose.
  • Redness of the eye
  • Swelling and cloudiness of the cornea

The problem is likely to be herpes simplex keratitis if your doctor sees these symptoms:

  • Pain in and around only one eye
  • Redness of the eye
  • Feeling of dirt or "grit" in the eye
  • Overflowing tears
  • Pain when looking at bright light
  • Swelling or cloudiness of the cornea

Your eye doctor might want to use special tests if it looks like herpetic eye disease might be present. The pressure inside the eye will probably be checked, for example. There is also a special dye called fluorescein that the doctor might put into the eye. This dye glows under ultraviolet light and will show the doctor if the virus is causing problems on the surface of the eye.

How is herpes zoster ophthalmicus treated?

Because herpes is a virus, antibiotics such as penicillin are not an effective treatment. The only drugs that will work against herpes infections are antiviral medications.

Depending on how serious the herpes zoster ophthalmicus is and what part of the eye is affected, your doctor will recommend antiviral eye drops, tablets, or both. Whatever kind of medication is recommended, it is important to keep using the medicine for as long as your doctor recommends. Even though the eye might start to look or feel better, the infection could come back if you stop taking your medicine too soon.

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