Eye Health and Herpes Viruses

Medically Reviewed by Whitney Seltman, OD on August 20, 2022
3 min read

You can get herpes in your eye, but it isn’t the same kind you get from sex. Two types of herpes viruses can lead to serious eye problems. One also causes cold sores, and the other also leads to chickenpox.

Neither is the same strain that causes genital herpes. That means you can’t get the eye problems, which your doctor might call herpetic eye disease, from having sex.

The varicella-zoster virus is the one that causes chickenpox and shingles. When it affects your eye, it’s called herpes zoster ophthalmicus.

Herpes simplex type 1, or HSV1, which causes cold sores on your lips and mouth, can also lead to eye problems. It usually results in an infected cornea. Your doctor will call this herpes simplex keratitis. Herpes simplex type 2 (HSV2) can also cause keratitis, mostly in newborns, but it’s rare.

Like many viruses, these two are probably both already in your body and have been for a while. They live near your nerve fibers but usually don’t cause problems. Outbreaks happen when viruses multiply or move from one area of your body to another. A weakened immune system makes it more likely that you’ll have an outbreak.

The viruses have different symptoms. But each can be painful since they irritate your nerves.

Symptoms of herpes zoster ophthalmicus include:

  • Severe pain on one side of the face, in your scalp, or around your eyes
  • Redness, rash, or sores on your eyelids and around the eyes, especially on the forehead
  • A rash on the tip of your nose
  • Eye redness
  • A swollen or cloudy cornea

If symptoms involve only your eye, it’s probably herpes simplex keratitis. You might notice:

  • Pain in and around one eye
  • Eye redness
  • A feeling of dirt or grit in your eye
  • Overflowing tears
  • Pain when you look at bright light
  • Cloudy or swollen cornea

Your doctor may check your eye pressure and use special dye to study the surface of your cornea.

It’s the same for both conditions. Because herpes is a virus, antibiotics won’t work. Some medications can help, but you have to get them within 5 days or so after symptoms start.

Your doctor will prescribe antiviral eye drops, pills, or both. Take what they give you for as long as they say to take it. Your eye might start to look or feel better soon, but the infection could come back if you stop treatment too soon.

They might also give you steroid eye drops. They can control the disease if you get them at the right time, but they can also raise eye pressure. You’ll need regular office visits during treatment so the doctor can keep track of it.

You could also get an eye drop that keeps your pupil dilated (open). It will prevent spasms in your eye muscles and ease your pain.

It might start to look better after a few days, but still hurt. That doesn’t mean that treatment isn’t working. The medications will do their job, and the pain will go away.

It’s rare, but if you have the kind of virus that causes shingles, your eye could hurt for weeks or months. If that happens, your doctor might try other options, like sending you to a chronic pain specialist.