Herpes is a very common virus, which can affect the skin, mucous membranes, nervous system, and the eyes. There are two types of herpes simplex virus(HSV). Type I causes cold sores or fever blisters and may involve the eye. Type II is sexually transmitted and rarely causes ocular problems. Approximately 90% of the population over the age of 15 has been exposed to type I herpes virus . The herpes simplex virus is contagious and can be transferred from one part of the body to another (i.e., if one touches a cold sore then the eye, one can infect the ocular tissues). When the eye is involved, a herpes simplex typically affects the eyelids, conjunctiva and cornea . Keratitis(swelling caused by the infection), a problem affecting the cornea, is often the first ocular sign of the disease. In some cases, the infection extends to the middle layers of the cornea, increasing the possibility of permanent scarring. Some patients develop iritis or uveitis, an inflammatory condition that affects other areas inside the eye.

Symptoms

The disease may cause mild fever, malaise and swollen lymph nodes. The keratitis presents as redness in the involved eye with a variable degree of pain or visual irritation. Vision may or may not be affected, depending on the location and extent of the problem. The recurrent herpetic infection of cornea varies largely. It may start with minimal symptoms of a foreign body sensation, watering and mild light sensitivity. Although a skin rash and conjunctivitis may occur with the initial infection, this is less common with recurrent Herpes keratitis. Secondary uveitis or iritis is a more common sign of recurrence.

Diagnosis

Herpes keratitis is diagnosed with a slit lamp examination in our office. Tinted eye drops that highlight the affected areas of the cornea may be instilled to evaluate the extent of the infection.

Treatment

The primary herpic infection is self-limiting and responds well to use of antiviral eye drops, systematic medication and/or ointments. Artificial tears will also relieve some of the discomfort caused by the infection. At times it may be necessary to scrape the surface of the cornea. Cornea transplant may be required in case of severe scarring and vision loss.