Most people are surprised to find out that two types of herpes viruses -- the one that causes cold sores and the one that causes chickenpox -- can cause serious eye problems.
Neither of these two viruses are the same virus that causes genital herpes and herpetic eye disease is not a sexually transmitted disease.
One of the viruses that causes herpetic eye disease is the varicella-zoster virus. It also causes chickenpox and the nervous system disease shingles. When this virus affects the eye, it is called herpes zoster ophthalmicus.
The other virus that causes herpetic eye disease is herpes simplex type 1, or HSV1. Herpes simplex type 1 is the same virus that causes cold sores on the lips and mouth. In the eye, it usually causes an infection of the cornea called herpes simplex keratitis. Herpes simplex type 2 can cause keratitis, particularly in newborns, but less frequently.
Like many viruses, the herpes simplex 1 and varicella-zoster viruses are present in most adults, since they usually infect someone earlier in life. The viruses in the herpes family usually live around the nerve fibers in humans without ever causing a problem. Occasionally, the viruses will multiply or move from one area of the body to another, and that is when herpetic disease breaks out. Outbreaks often happens when the body's immune system is weakened by some other health problem.
How Is Herpetic Eye Disease Diagnosed?
The two types of herpetic eye disease have different symptoms. One thing they have in common, however, is that they can both be very painful since they cause direct irritation of sensory nerves. Symptoms of herpes zoster ophthalmicus include:
Severe pain on one side of the face, in the scalp, or around the eyes.
Redness, rash, or sores on the eyelids and around the eyes, especially on the forehead. Sometimes the rash breaks out on the tip of the nose.
Redness of the eye.
Swelling and cloudiness of the cornea.
The problem is more likely to be herpes simplex keratitis if your symptoms are isolated to the eye and the skin around the eyes is unaffected. Symptoms of herpes simplex keratitis include:
Pain in and around only one eye
Redness of the eye
Feeling of dirt or "grit" in the eye
Pain when looking at bright light
Swelling or cloudiness of the cornea
Your doctor may check your eye pressure and use fluorescent dye to show the condition of the surface of your cornea.
How Is Herpes Zoster Ophthalmicus Treated?
Because herpes is a virus, antibiotics are not an effective treatment. There are specific antiviral medications that can treat the condition but they must be given early enough -- within five days or so of the onset of symptoms.