Herpesviruses live around the nerve fibers of most adults and usually don’t cause problems. But when a person’s immune system is weakened, these viruses can start to multiply and cause symptoms.
When an ocular herpes outbreak occurs, a painful blistering rash can appear on the skin around your eye, forehead, and tip of your nose or also on the surface of your eye (the cornea).
Ocular herpes is worrisome because it can cause scarring, vision loss, and other long-term problems.
Herpes simplex Type I is the same virus that causes cold sores on the lips and mouth. In the eye, it usually infects the cornea. This is known as herpes simplex keratitis. It typically affects the outermost corneal layer, called the epithelium, and heals without scarring.
In about 25 percent of cases, the virus infects the deeper corneal layer known as the stroma (called stromal keratitis). This is more serious because it can lead to scarring and vision loss. The virus can also infect the iris and surrounding tissues (iridocyclitis) as well as the retina which is the inside lining of the back of the eye (herpes retinitis).
The Varicella-zoster virus is the same virus that causes chickenpox and shingles. When it affects the eye, it’s called herpes zoster ophthalmicus. Once you’ve had chickenpox, the virus stays dormant in your body and hides in nerve cells near your spinal cord. The virus can reactivate decades later anywhere on your body. In about ten to twenty percent of people with shingles, the flare-up occurs in and around the eye.
Actually, the two types of herpetic eye disease have different symptoms, although both have eye pain in common. The symptoms help your doctor identify which virus is the culprit causing the outbreak.
Unfortunately, there can be long-term side effects following a herpes outbreak. Although the rash will fade after a few weeks, the pain can continue for weeks or months. This is due to nerve damage caused by the virus and it’s known as post-herpetic neuralgia.
Also, if herpes has infected your cornea, it can result in corneal ulcers creating permanent scars that lead to loss of vision. Lastly, your eye pressure can increase, leading to glaucoma.
Typically, your eye doctor can determine if you have ocular herpes just by looking at the rash on your eyelids, face, and scalp. Identifying which virus is the culprit depends on your symptoms. Your eye specialist may want to take a fluid sample from the blisters and send it to the lab to confirm which form of herpes is present.
You, eye specialist, might also check the pressure inside your eye. In addition, your doctor might place fluorescein dye eye drops in your eye and examine it under ultraviolet light in order to check for damage to the surface of your cornea.
You’re at increased risk of getting ocular herpes if:
While the exact cause of a herpes virus outbreak is unknown, there seem to be stress-related factors associated with virus reactivation. These triggers include fever, sunburn, major surgical or dental procedures, and trauma. Herpetic eye disease is not sexually transmitted, and the virus is different from the one that causes genital herpes.
The herpes simplex virus enters the body through the nose or mouth and travels to the nerves, where it settles and can remain dormant for years. It’s possible that it may never wake up. However, once an initial outbreak occurs, untreated eye herpes has about a forty to fifty percent chance of returning.
The herpes zoster virus is transmitted through contact with someone who’s having an outbreak or through self-contact by touching a cold sore and spreading the virus to another part of your body. The virus is in its contagious stage when there are visible blisters present.
If you have a herpes zoster outbreak, it’s important to avoid close contact with anyone who’s never had chickenpox because you can transmit the virus to them and cause them to have a case of chickenpox. This is particularly dangerous for people with weakened immune systems, pregnant women and children.
While there’s no prevention for the herpes simplex virus, you can prevent the varicella-zoster virus (shingles) by getting a vaccine. In fact, the Center for Disease Control (CDC) actually recommends this vaccine for folks 60 and older because it cuts your risk of getting shingles by more than fifty percent.
What’s more, the shingles vaccine can reduce your odds of having long-term nerve damage by more than 66 percent
The Assil Gaur Eye Institute is nationally recognized for its legacy of compassionate patient-centric care, its commitment to pioneering advances in ophthalmology, and its dedication to supporting the health and well-being not only of its patients but also of its community.
Dr. Assil has assembled a team of top Ophthalmology specialists from around the country to offer our patients the highest quality of Specialist care within the comfort and familiarity of our Los Angeles offices. Our two locations allow patients to choose the clinic that's most convenient to their home or office.
Dr. Harris provides comprehensive eye care examinations, treatment, and management of ocular diseases, as well as pre and post operative care for cataracts, LASIK, and corneal transplants.
She specifically works with Dr. Assil in preparing pre-surgical plans for all of his intraocular lens procedures. Dr. Harris has also has assisted in numerous FDA supervised clinical trials and continuing education events.