Ocular herpes is an infection caused by the herpes simplex virus type 1 or type 2. It leads to symptoms that are often similar to conjunctivitis, such as itching, swelling, redness, eye irritation, excessive tearing, or blurred vision.
A herpes virus infection in the eyes can affect one or both eyes and may cause inflammation of the eyelids, conjunctiva, iris, retina, or cornea. In more severe cases, ocular herpes can lead to serious complications, including permanent blurred vision or complete vision loss.
For this reason, it is important to consult an ophthalmologist as soon as symptoms of ocular herpes appear. Early evaluation allows the diagnosis to be confirmed and the most appropriate treatment started, which may include antiviral or corticosteroid eye drops, among other options.
Common symptoms
The main symptoms of ocular herpes include:
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Redness;
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Eye irritation or pain;
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Swelling around the eye;
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Inflammation of the eyelids;
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Sensitivity to light;
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Excessive tearing;
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Blurred vision;
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Itchy eyes;
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Blisters or ulcers with a reddish border and fluid on the skin near the eye.
In addition, ocular herpes may cause inflammation of the cornea, known as keratitis. Along with the symptoms listed above, keratitis can cause difficulty opening the eyes due to pain and irritation, as well as the formation of small blisters or ulcers on the cornea.
It is important to see an ophthalmologist as soon as the first symptoms appear so the diagnosis can be made and treatment started promptly, reducing the risk of complications, including blindness.
Confirming a diagnosis
Ocular herpes is usually diagnosed clinically by an ophthalmologist, who assesses the patient’s symptoms, the timing of their onset, and examines the eye with a slit lamp to evaluate the appearance of the lesions.
If there is uncertainty about the diagnosis, the doctor may collect a sample of discharge from the eye to be analyzed at the lab to confirm the presence of the herpes simplex virus (HSV).
Possible causes
Ocular herpes is caused by infection with herpes simplex virus type 1 or type 2 and most often occurs when a previous herpes infection is reactivated.
Several factors can contribute to reactivation of the virus, including:
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Fever;
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Excessive sun exposure;
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Eye injuries;
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A weakened immune system;
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Stress;
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Radiotherapy or chemotherapy;
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Use of corticosteroids.
In addition, herpes simplex virus type 2 can be transmitted from mother to baby during vaginal delivery if the mother has an active genital infection or if the first infection occurs during the third trimester of pregnancy.
Ocular herpes can also develop through accidental contact with fluid from cold sore blisters on the lips, when a person touches the blister and then touches their eyes without washing their hands.
Treatment options
Treatment for ocular herpes must be guided by an ophthalmologist and may include:
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Antiviral eye drops or ointments to prevent the virus from multiplying;
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Corticosteroid eye drops, which may be used together with antivirals to reduce eye inflammation;
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Oral antiviral medications in tablet form, such as acyclovir or valacyclovir, for severe infections or to prevent recurrence;
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Antibiotic eye drops or ointments to help prevent secondary infections caused by bacteria or fungi in herpes-related lesions.
Starting treatment as early as possible is essential to reduce the risk of complications from ocular herpes, including blindness.
Possible complications
Ocular herpes usually does not cause serious complications when treated promptly. However, in more severe cases or when left untreated, the risk of complications increases.
Possible complications include scarring of the cornea, which can cause permanent blurred vision and may require a corneal transplant. Ocular herpes can also increase the risk of other eye infections caused by bacteria or fungi, as well as the development of glaucoma or complete vision loss.