What is a herpes infection of the cornea?

A herpes infection of the cornea, also known as herpes keratitis, is an eye condition caused by the herpes simplex virus (HSV). This infection affects the cornea, the clear, dome-shaped surface at the front of the eye. Herpes keratitis is the most common cause of infectious blindness in developed countries.

What causes herpes keratitis?

The herpes simplex virus causes herpes keratitis, typically HSV-1 (commonly associated with cold sores). It can occur when:

• The virus is reactivated after lying dormant in the body, often triggered by stress, illness, or sunlight exposure.
• The virus spreads to the eye through direct contact, such as touching the eyes after a cold sore.

What are the symptoms of herpes keratitis?

Symptoms can range from mild to severe and may include:

• Redness and irritation in one eye.
• Eye pain or a gritty sensation.
• Blurred or decreased vision.
• Sensitivity to light (photophobia).
• Watery or sticky discharge.
• Swelling around the eye.

How is herpes keratitis diagnosed?

An eye specialist will perform:

1. Eye Examination: Using a slit lamp to check the cornea for signs of infection.
2. Fluorescein Staining: A special dye helps highlight corneal damage.
3. Laboratory Testing: In rare cases, a sample from the cornea is tested to confirm the presence of HSV.

What are the types of herpes keratitis?

1. Epithelial Keratitis: Involves the cornea’s outer layer (epithelium). It is often mild but can cause recurrent infections.
2. Stromal Keratitis: Affects deeper layers of the cornea, leading to scarring and potential vision loss.
3. Endothelial Keratitis: Targets the innermost corneal layer, causing swelling and severe vision problems.

How is herpes keratitis treated?

Treatment depends on the severity and type of infection:

• Antiviral Medications:
  • Eye drops (e.g., trifluridine) or oral antiviral drugs (e.g., acyclovir or valacyclovir) are the primary treatments.
  • These help control the virus and reduce the risk of complications.
• Corticosteroids:
  • For stromal keratitis, steroids may be prescribed to reduce inflammation, but they must be used carefully under medical supervision.
• Debridement:
  • The removal of infected cells from the corneal surface to promote healing.
• Corneal Transplant:
  • In severe cases with significant scarring, surgery may be needed to restore vision.

Can herpes keratitis cause complications?

If untreated, herpes keratitis can lead to:

• Permanent corneal scarring.
• Chronic inflammation.
• Vision loss or blindness.

How can I prevent herpes keratitis?

• Avoid touching your eyes, especially if you have a cold sore.
• Wash hands frequently and practice good hygiene.
• Use antiviral medications as prescribed to reduce the risk of recurrence.
• Protect your eyes from excessive sunlight by wearing UV-blocking sunglasses.

When should I see a doctor?

Seek immediate medical attention if you experience:

• Persistent eye pain or redness.
• Sudden vision changes.
• Sensitivity to light or discharge from the eye.

What is the prognosis for herpes keratitis?

With timely treatment, most cases of herpes keratitis resolve without serious complications. However, long-term care and preventive measures are essential because the virus can reactivate. Regular follow-ups with an eye doctor can help monitor and manage the condition effectively.