Herpes Keratitis

What is Herpes Keratitis

Herpes keratitis is an eye infection that is caused by the herpes simplex virus (HSV). This infection can cause eye symptoms and eye damage.

Most of the time, herpes keratitis affects only the surface of the clear covering at the front of the eye (cornea). Sometimes, the virus affects the deeper layers of the cornea and causes ulcers, scarring, and vision loss.

What are the causes?

This condition is usually caused by a type of HSV called herpes simplex virus 1 (HSV-1). This type also causes cold sores and fever blisters around the mouth. You can infect your eye if you touch an active sore or blister and then touch your eye.

After you have a herpes infection for the first time (primary infection), the virus stays in your system. It can live in the roots of your nerves and cause another infection at a later time (latent infection).

What increases the risk?

This condition is more likely to develop in people who have already had a herpes keratitis infection, especially if they also wear contact lenses.

What are the signs or symptoms?

Symptoms of this condition usually occur in only one eye at a time. Symptoms include:

  • Pain and redness in the affected eye.
  • Sensitivity to light.
  • Blurred vision.
  • More tears than usual.
  • Feeling like there is something in the eye.
  • Blisters on the eyelid.
  • Loss of vision.
  • A discoloration or haziness of the cornea.

How is this diagnosed?

This condition may be diagnosed based on your symptoms and an eye exam. If your health care provider suspects herpes keratitis, you will need to see an eye specialist (ophthalmologist). An ophthalmologist will diagnose herpes keratitis by:

  • Examining your eye.
  • Placing a type of dye into your eye and then examining your cornea with a microscope (slit lamp). This exam may show a type of ulcer on your cornea caused by the infection (dendritic ulcer). If the slit lamp exam does not show the typical ulcer, a sample from a lesion on your cornea may be sent to a lab and tested for HSV.

How is this treated?

There is no cure for herpes keratitis, but treatment can prevent eye damage. Treatment will depend on the severity and type of infection. Repeated (recurrent) infections tend to be more serious and cause more symptoms. Treatment options may include:

  • Antiviral eye drops or oral antiviral medicine.
  • A procedure to scrape diseased tissue off the cornea. This may be done for a superficial infection.
  • Corneal transplant surgery. This may be needed for a deep corneal infection that causes scarring and loss of vision.

Follow these instructions at home:

  • Use or take over-the-counter and prescription medicines only as told by your health care provider.
  • Do not use any over-the-counter eye drops unless your health care provider approves. These drops may contain a steroid medicine that can make your infection worse.
  • Do not touch a cold sore and then touch your eye or contact lenses. Wash your hands often.
  • If you wear contacts:
    • Remove the lenses if you develop symptoms of herpes keratitis.
    • Ask your health care provider if you should switch to regular glasses if you have had a recurrent herpes keratitis infection.
  • Keep all follow-up visits as told by your health care provider. This is important.

Contact a health care provider if:

  • You develop new symptoms of herpes keratitis.
  • Your symptoms are not getting better.
  • You have a fever.

Get help right away if:

  • You have sudden vision loss.

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