Herpes simplex is a disease caused by the herpes simplex virus (HSV). This virus usually causes painful cold sores or fever blisters on the lips and nearby skin, including in the nose and mouth. However, it can also affect the eyes and other parts of the body.
HSV is very common. About 90% of adults have had the infection. HSV is spread through contact with fluid from the blisters. The infection can be spread, for example, by kissing, by sharing food or drink, or by not washing your hands after touching the sores. Most people have their first outbreak (symptoms) during childhood or the early teens.
Once you are infected, the virus continues to live in the body, even after the sores are gone. The virus may become active again during or after:
Usually, the cause of outbreaks is unknown.
In some people, HSV eye outbreaks recur often. If not treated, repeated sores can seriously damage the cornea (the clear outer layer on the front of the eye).
The symptoms of HSV eye infections are:
HSV often affects just one eye.
Herpes simplex eye infections can be hard to diagnose. They can cause the same symptoms as allergies, other viruses, and reactions to some medicines.
Your healthcare provider will examine your skin and eyes and ask about your medical history. Fluid from the eye surface or your skin may need to be tested in the lab to make a definite diagnosis.
Often herpes simplex eye symptoms go away without any treatment. Other times your healthcare provider will prescribe medicines in the form of eyedrops, ointments, or pills to decrease the number of days you have symptoms and speed your recovery. You may also need medicine to treat a more severe inflammation inside the eye. Rarely, surgery, such as a corneal transplant, is needed to remove scars caused by herpes infection of the cornea. A rare problem in the back of the eye, called retinitis, may need to be treated with medicines injected into the back of the eye.
Your symptoms may go away in a few days or weeks. Blisters on the eyelids, like cold sores, go away completely without long-term effects. As a general rule, the deeper inside the eye the infection is, the more likely that the effect will last longer. Repeated outbreaks (symptoms appearing days, weeks, or years after the initial symptoms have healed) are more likely to cause permanent scarring than the first outbreak.
Neither your immune system nor the medicines can get rid of the virus completely. After the first outbreak, HSV may not cause any problems for months or years. Then sores may reappear when your immune system is weakened by disease or stress. Sometimes HSV is active but you do not have any blisters.
Because herpes simplex virus is so common, you probably cannot prevent your first outbreak. If you keep getting symptoms, your provider may prescribe antiviral medicine to help prevent future outbreaks. This may help you lessen how often and how severe future outbreaks may be.
Although HSV is contagious, the spread of an HSV eye infection to another person is rare.
