The enemy has stealthily entered your home. But you go about your daily routine blissfully unaware of this. Days turn into months and months roll into years. The enemy silently and patiently waits behind the curtains for his chance. Suddenly one day, like a bolt out of the blue, the enemy catches you unawares. Taking advantage of your lowered defenses, the enemy strikes you right in the eye! And before you know it, you are enveloped in a world of darkness…
Did you just dismiss the above as a fictional Spy Story? Would you be surprised if you were told that this is the true story of what Herpes does to your eyes?
Eye Herpes or Ocular Herpes is an infection of the eye caused by the Herpes virus. The Herpes virus is of two types: One, called the Varicella Zoster Virus which is the same virus that causes chickenpox and shingles. The other, called the Herpes Simplex Virus Type 1 is the one that causes cold sores on your lips and mouth. This article deals with Herpes Simplex eye infections.
Approximately 1 or 2 people in a thousand experience at least a single episode of active herpes simplex infection in their eye. The most common age for this is 30 – 40 years.
The Herpes Simplex Virus can enter your body through your nose or mouth. It is commonly passed on by close contact like a kiss from a family member who is suffering from a cold sore. It may also find its way to your eyes if you have a cold sore yourself. For the first time that this virus finds its way into your body; you may or may not have any symptoms. After this, the virus is your body’s guest for life. The virus may remain inactive for years and never wake up. Or, it may become active and start multiplying. Situations where your body’s immune system is weakened help the virus to activate.
• Herpes Keratitis: In this form, usually only the top layer of your cornea (the transparent outer surface of your eye) called the epithelial layer is affected. This generally heals without any scar formation.
• Stromal Keratitis: When the infection affects the deeper layers of your cornea, it can cause scarring, vision loss and even blindness.
• Iridocyclitis: This is a severe form of ocular herpes where your iris (the coloured part of your eye) and the neighbouring tissues become inflamed. This causes intense light sensitivity, blurriness of vision, redness and pain.
• Eye pain
• Sensitivity to light
• Redness of your eye
• Feeling of dirt or grit in your eyes.
• Watering of your eyes
• Blurry Vision
You may have a history of having a similar episode or having a cold sore in the past.
Usually only one eye is affected.
Examination of your eye
Slit Lamp Examination
Your eye pressure may be tested
A dye called Fluorescein may be put into your eye to check for abrasions or ulcers on your cornea.
Sometimes, a sample of the tissue from your eye may be taken to identify the virus.
1. Debridement: Your eyes are numbed before the procedure. The infected cells are scraped away from your eye surface.
2. Epithelial Keratitis: If it is just the top layer of your cornea that is affected, antiviral eye drops are prescribed. These stop the virus from multiplying further. They are not able to kill the virus and the main aim is to prevent damage to your cornea.
3. Stromal Keratitis: If the deeper layer of your cornea is also affected, in addition to antiviral eye drops, steroid eye drops may also be given. This must be used in strict accordance with your doctor’s prescription.
4. Surgery: If scarring has already occurred and the above treatments do not help, corneal transplantation may be required to restore vision.
If you use contact lenses, you must stop wearing them until the infection has been taken care of.
Epithelial Keratitis: This usually settles down in a few weeks. It does not usually cause much scarring.
Stromal Keratitis: This is more likely to cause scarring and hence loss of vision. Severe scarring can even cause blindness.
Other factors like whether you have received prompt treatment, whether this is a recurrent episode etc. all affect the prognosis in your case.
Usually 9 out of 10 people suffering from an active herpes simplex eye infection come out of it with a vision good enough to drive.