An infection of the cornea, the transparent front part of the eye, caused by a viral infection. This infection can affect multiple layers of the cornea and cause inflammation, and may extend to affect the deeper parts of the eye, such as the iris, leading to inflammation inside the eye. In the following lines, through the Dalili Medical website, we will review the causes of this condition, its symptoms, and ways to prevent it.

**What is eye herpes?**

 

Herpes of the eye, also known as herpes of the eye, is a viral infection of the eye caused by the herpes simplex virus type 1 (HSV-1). This virus is the same virus that causes cold sores around the mouth and lips. In most cases, eye herpes (herpes of the eye) affects the cornea of ​​the eye, in which case it is known as herpes keratitis caused by the herpes virus. (Where the word "kerato" in Latin means "cornea" and "itis" means "inflammation").

Eye herpes can affect the surface cells of the cornea (epithelial herpesvirus keratitis) or the main body of the cornea (stromal herpesvirus keratitis). Stromal herpesvirus keratitis can lead to corneal scarring and loss of vision.

HSV-1 also often causes inflammation of the iris and associated tissues in the front of the eye (traumatic uveitis) or inflammation of the retina in the back of the eye (herpes retinitis).

**Can eye herpes be cured?**

 

To date, there is no antiviral treatment that can completely eliminate iris herpes. Herpes viruses remain in the cells of the nervous system, where they remain inactive for long periods of months or years. No treatment has been developed that can eliminate the viruses in their latent state.

**Is eye herpes dangerous?**

 

The more frequent and recurrent infections, the greater the risk of damage to the surface of the cornea. Repeated recurrences of infection can lead to deep ulcers, permanent scarring, and the formation of blood vessels in the cornea, in addition to a feeling of numbness on the surface of the eye. Recurrent HSV infection can lead to a severe deterioration in vision, which may be permanent.

**Where does eye herpes come from?**

 

**Causes and risk factors**: HSV infection is transmitted through the mucous membrane or through secretions of the infected mucous membranes, such as from mouth to mouth, or from saliva or tear fluid contaminated with the virus to the eye. Once the virus infects the eye, it becomes impossible to eliminate it.

**Duration of eye herpes**: After learning about eye herpes, let's look at how long the infection lasts. Both viruses can remain in the body and remain dormant for life. However, when the immune system is weakened by a certain disease, the risk of one of these viruses waking up increases, causing herpes to appear in a specific area of ​​the body.

Herpes on the eyelids can be annoying and unsightly, and it can also pose a risk to visual health. Many people wonder how long eye herpes lasts, but it is difficult to give an accurate answer, as each person reacts differently to this infection. Eye herpes usually disappears within a few days of starting treatment, usually within 5 to 10 days. However, as with cold sores, the appearance of herpes becomes a periodic condition, which means that it can recur from time to time.

Is eye herpes contagious?

 

Indeed, herpes on the eyelids or eyes can be contagious if there is direct contact with one of these lesions and the virus causing the condition is active. In other words, if you have had previous attacks and touched someone else’s herpes, there is a high chance of transmitting the infection. Even touching a lesion on the lips and then rubbing your hands over your eyes can lead to eye herpes in people who carry an active virus. However, if you have never had eye herpes before, the risk of infection is much lower, or there may be no infection at all, just as is the case with labial herpes.

**Types of Herpetic Keratitis**

Herpetic keratitis is classified based on which layer of the cornea is affected, as well as whether the infection is caused by a direct infection with the virus or by an inflammatory reaction resulting from it:

. **Epithelial keratitis**: In this type, the virus invades the corneal epithelium, resulting in linear, branching lesions known as dendritic ulcers. If these ulcers are not treated, they may expand and grow, creating a map-like appearance, called geographic ulcers. The longer treatment and healing are delayed, the more scars the infection may leave, leading to permanent loss of visual acuity, especially if the central area of ​​the cornea is affected.

. **Immuno-stromal keratitis**: This type occurs after epithelial keratitis, where the virus enters a dormant state. This inflammation is due to the presence of virus particles within the stroma layer of the cornea, without the presence of active virus. The cornea becomes swollen or "swelled", causing vision loss, while the corneal epithelium remains intact.

**Endotheliitis** is a direct viral infection that causes secondary inflammation of the endothelium, the innermost layer of the cornea. This causes an inflammatory reaction inside the eyeball, causing the cornea to swell. White blood cells are also found attached to the endothelium, as well as in the aqueous fluid that fills the inside of the eyeball.

What causes herpes keratitis?

 

Herpes keratitis is caused by infection with the herpes simplex virus type 1, a highly contagious virus that is often spread through skin-to-skin contact with an infected person. About 90% of people are infected with this virus, usually during childhood.

After infection, the virus remains dormant and lives inside nerve cells in the skin or eye, and can be reactivated in a number of ways, such as:

- Psychological stress.- Damage caused by exposure to sunlight.

- Fever.

- Trauma to the body (such as injuries or surgeries).

- Menstruation.

- Some medications.

Herpetic keratitis can also be caused by the herpes zoster virus, also known as "shingles". The symptoms, effects, and treatment in this case are different from those caused by the herpes simplex virus.

**Symptoms of eye herpes**

Eye herpes can cause a variety of symptoms, some of which may not be directly related to the eye, such as headache. The symptoms that appear on the infected person vary depending on the type of herpes virus that caused the eye herpes, and the most prominent of these symptoms are:

. **Symptoms of eye herpes caused by the herpes simplex virus:**

- Pain inside the eye or around one of the eyes. 

- Decreased visual acuity. 

- Feeling pain when exposed to bright light. 

- Swelling or cloudiness of the cornea. 

- Redness of the eye.

- Increased tearing. 

- Feeling of dirt or a foreign body in the eye.

. **Symptoms of eye herpes caused by the varicella zoster virus:**

These are the most prominent symptoms:

- Redness and rash or ulcers on the eyelid and around the eye, or even ulcers inside the eye itself.

- A feeling of numbness or tingling in the eye area, which may precede the appearance of the aforementioned rash.

- Symptoms similar to those of the flu, such as: mild fever and a general feeling of weakness.

- Other similar symptoms, such as: pain in or around the eye, redness of the eye, swelling of the cornea or blurred vision.

The eye herpes virus can lead to permanent damage to the eye, which may cause blindness.

**Diagnosis of eye herpes**

Accurate diagnosis of eye herpes is vital to ensure effective treatment. An ophthalmologist can make a diagnosis through:

- **Medical examination in the office**: Performing a comprehensive eye examination using a slit lamp to detect signs of infection and inflammation.

- **Viral culture**: Collecting a sample from the eye to determine the presence of herpes simplex virus.

- **Polymerase chain reaction (PCR)**: A highly sensitive test that aims to detect herpes simplex virus DNA in eye tissue.

- **Fluorescein stain**: Applying a fluorescent dye to the eye to highlight corneal ulcers and any damage that may have occurred.

**Ocular herpes treatment options**

**Antiviral medications**Antiviral medications are the mainstay of treatment for eye herpes, as they help reduce the reproduction of the virus and relieve symptoms. Common antiviral medications include:

- **Acyclovir (Zovirax)**: Available in oral and topical forms, it is effective in reducing the severity and duration of attacks.

- **Valacyclovir (Valtrex)**: Taken orally, it is better absorbed and has longer lasting effects than acyclovir.

- **Trifluridine (Viroptik)**: A topical antiviral eye drop used to treat corneal infections.

**Corticosteroids** Corticosteroids may be prescribed to reduce inflammation and prevent scarring in cases of stromal keratitis or severe inflammation. However, these medications should be used with caution and monitored to avoid potential side effects, such as increased eye pressure and glaucoma.

**Pain management** Over-the-counter pain relievers, such as ibuprofen or acetaminophen, can help relieve discomfort and pain associated with ocular herpes. In some cases, prescription pain relievers may be necessary.

**Preventing recurrence** Preventing recurrence of ocular herpes is an essential part of managing it. Strategies include:

- **Preventive antiviral therapy**: Long-term use of antiviral medications to reduce the frequency and severity of attacks.

- **Stress management**: Apply techniques such as meditation and yoga, as well as counseling, to help reduce stress and triggers.

- **Good hygiene practices**: Make sure to wash your hands regularly and avoid touching your eyes to reduce the spread of the virus.

**Pain management**Over-the-counter pain relievers, such as ibuprofen or acetaminophen, can help relieve discomfort and pain associated with ocular herpes. In some cases, prescription pain relievers may be necessary.

**Prevent recurrence**Preventing recurrence of ocular herpes is an essential part of managing it. Strategies include:

- **Preventive antiviral therapy**: Use of long-term antiviral medications to reduce the frequency and severity of attacks.

- **Stress management**: Apply techniques such as meditation and yoga, as well as counseling, to help reduce stress and triggers.

- **Good hygiene practices**: Make sure to wash your hands regularly and avoid touching your eyes to reduce the spread of the virus.