Herpes and the Eye

Introduction to Herpes Viruses and the Eyes

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.

These two viruses are not the same virus that causes genital herpes, and herpetic eye disease is not a sexually transmitted disease.

One of the viruses that cause herpetic eye disease is called the varicella-zoster virus. It is the same virus that 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 called herpes simplex type 1. 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. This infection is called herpes simplex keratitis.

How Does Herpetic Eye Disease Develop?

Like many viruses, the herpes simplex 1 and varicella-zoster viruses are present in most adults. The viruses in the herpes family usually live around the nerve fibers in humans without ever causing a problem. Occasionally, the viruses will start to multiply, or they will move from one area of the body to another, and that is when herpetic disease breaks out. This often happens when the immune system of the body 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 because they affect the nerves directly. The problem is likely to be herpes zoster ophthalmicus if your doctor finds some or all of these symptoms:

• Pain in and around only one eye
• 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 likely to be herpes simplex keratitis if your doctor sees these symptoms:

• Pain in and around only one eye
• Redness of the eye
• Feeling of dirt or "grit" in the eye
• Overflowing tears
• Pain when looking at bright light
• Swelling or cloudiness of the cornea

Your doctor might want to use special tests if it looks like herpetic eye disease might be present. The pressure inside the eye will probably be checked, for example. There is also a special dye called fluorescein that the doctor might put into the eye. This dye glows under ultraviolet light and will show the doctor if the virus is causing problems on the surface of the eye.

How Is Herpes Zoster Ophthalmicus Treated?

Because herpes is a virus, antibiotics such as penicillin are not an effective treatment. The only drugs that will work against herpes infections are antiviral medications.