Herpes simplex eye infections

Page last reviewed: 13/07/2011

Herpes simplex eye infections are eye infections caused by the herpes simplex virus - the same virus that can cause cold sores and genital herpes.

The infection can cause redness and pain in or around the eye and sensitivity to light

Some people with a herpes simplex eye infection do not have any noticeable symptoms.

Who is affected

Herpes simplex eye infections are quite common and usually affect the middle-aged.

Outlook

A herpes simplex eye infection is not usually serious, but see your GP immediately if you have symptoms. You may need to use eye ointment or drops to clear up the infection

In some cases, a herpes simplex eye infection can permanently affect your eyesight if you do not get it treated straight away. 

Page last reviewed: 13/07/2011

Some people with a herpes simplex eye infection do not have any noticeable symptoms.

Otherwise, symptoms include:

  • eye redness
  • moderate to severe pain in or around your eye
  • sensitivity to light (photophobia)
  • a watery eye
  • vision problems (for example, blurred vision)

You may also feel generally unwell or have a fever (a temperature above 38ºC or 104.4ºF).

Page last reviewed: 13/07/2011

Herpes simplex eye infections are usually caused by the herpes simplex virus type 1 (HSV-1). The HSV-1 virus can also cause cold sores on your face and, rarely, genital herpes.

A herpes simplex eye infection can also be caused by the herpes simplex virus type 2 (HSV-2). HSV-2  can also cause genital herpes and, rarely, cold sores on your face.

Triggers of a herpes simplex eye infection

If you have been exposed to the herpes simplex virus, it will usually remain dormant (inactive) in your blood. But it can be activated by certain factors, which can then lead to symptoms.

These trigger factors include:

  • another illness or an injury
  • exposure to strong sunlight
  • a fever (high temperature above 38°C)
  • exposure to cold winds
  • stress
  • (in women) having your period

Having a weakened immune system can also trigger regular cold sores or herpes simplex eye infections - for example, if you have HIV or are receiving chemotherapy treatment.

Page last reviewed: 13/07/2011

It is important to speak with your GP if you have symptoms of a herpes simplex eye infection. An untreated infection can permanently damage your eyes.

Your GP

Your GP will ask you about your symptoms and examine your eyes to rule out any other conditions.

They may put a harmless dye into your eye to see any irregular areas or injury. This is called fluorescein staining.

Your GP may also test your vision using a Snellen chart (a chart with blocks of letters that gradually get smaller).

Your eye specialist

If your GP thinks that you may have a herpes simplex eye infection, they will send you to an eye specialist (ophthalmologist) who will see you on the same day.

This is because herpes simplex infection is difficult to diagnose without specialist knowledge and equipment. It can also permanently affect your eyesight if it is not treated quickly.

In addition to the tests above, your eye specialist may take a sample of the fluid (tears) from your eye so that it can be tested in a laboratory.

Page last reviewed: 13/07/2011

Treatment of a herpes simplex eye infection depends on how bad the infection is and what part of the eye is affected.

Sometimes, your eye specialist may advise no treatment. If this is the case, you may be asked to visit your eye specialist regularly to make sure the infection clears up naturally and does not get worse.

Eye drops and ointments

Your eye specialist may prescribe eye drops or eye ointment that contain either:

  • antiviral medicine or
  • a corticosteroid (steroid medication, which reduces inflammation)

Sometimes, your eye specialist may advise you to take antiviral and steroid eye drops or ointment at the same time. This is because some research suggests that this can clear herpes simplex eye infections more quickly.

Eye cleaning

Before you start treatment with eye drops or ointment, your eye specialist may 'clean' your eye by gently scraping infected cells from its surface. This is also known as 'debridement'.

This is carried out under local anaesthetic (the eye is numbed) so you do not feel any pain while it is being done.

Tablets

Tablets are not normally used for treating a herpes simplex eye infection.

However, antiviral tablets may be prescribed after treatment to stop the infection returning. You may have to keep taking them for up to a year after the infection has gone.

Wearing contact lenses

It is best not to wear contact lenses until you have finished treatment and the symptoms have gone completely.

Page last reviewed: 13/07/2011

A herpes simplex eye infection is not usually serious. But in some cases, it can permanently affect your eyesight if you do not treat it quickly.

If you have symptoms, speak to your GP as soon as possible.

Complications of herpes simplex eye infections include:

  • scarring of your cornea (the front of your eye), which can cause vision problems and may require a cornea transplant (an operation to replace the cornea in your eye)
  • an ulcer on your cornea
  • further infections caused, for example, by bacteria or fungi
  • glaucoma (an eye condition that can affect your vision)

If you develop problems with your vision, this may affect your driving, and you should discuss this with your GP.

Content provided by NHS Choices www.nhs.uk and adapted for Ireland by the Health A-Z.

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