Ocular herpes, or herpes of the eye, is caused by the Type 1 herpes virus (the same one that causes cold sores) and afflicts nearly 40,000 new cases each year. Approximately 500,000 Americans have ocular herpes, and it is contracted by coming in contact with someone with an active Type 1 herpes infection (cold sore, fever blister). While it is still unknown as to the connection between ocular herpes and cold sores, it is believed that the immune system plays a part as to whether Type 1 herpes will spread as a virus from the face to the eye once contracted.
There are several different types of ocular herpes, with herpes keratitis being the most common. This is where the virus attacks the cornea of the eye (usually just one, but in rare cases both eyes can contract the virus), but usually only the top layer, and will heal on its own without scarring or permanent damage to the eye.
Stromal keratitis is a more severe form of ocular herpes, also affecting the cornea, but being deeper in the tissue of the cornea. It is thought to be caused by late immunity to the initial contraction of the virus, allowing it to bear deeper into the cornea. This form of ocular herpes can cause permanent scarring, loss of vision, and even blindness. While a more rare form of ocular herpes, it is believed to be a leading cause of blindness by corneal scarring in the United States.
Iridoclyclitis is where the ocular herpes infects the iris and surrounding tissues within the eye. When causing inflammation, sensitivity to light, blurry vision, and pain and redness in the eye will occur. When ocular herpes affects the retina of the eye, it is called herpes retinits.
You can transfer Type 1 herpes to your eye through self-transference (touching an active cold sore then touching your eye) or via contact with someone else who is having an active outbreak. The virus is transferred through the nasal cavity where it remains inactive until it may (or may not) become active sometime down the road. After an initial first outbreak, if it is left untreated, then there is up to a 50% likelihood that it will reoccur. In most cases, only one eye is effected. In many cases, the virus can be contracted and always remain dormant in the body. The body creates an immunity toward the virus, and it can be carried for years before an outbreak occurs, or an outbreak may never occur at all. Typically, the first outbreak of ocular herpes will be very soon after initially contracting the virus, and, like genital herpes, the 1st outbreak is usually the worst, with future outbreaks (if any) being less severe due to partial immunity the body naturally creates against the virus. However, if ocular herpes reoccurs after the first outbreak, the chances increase that there will be a third, or recurring outbreak. It is unknown if a second outbreak, or subsequent outbreaks, will occur once ocular herpes is contracted.
It’s unknown what causes any herpes outbreak, but stress or illness that weakens the immune system, are believed to be leading causes of a herpes outbreak due to the breakdown of the immune system that allows the dormant virus to activate. It’s unknown how often the outbreaks will occur in any herpes case, or if an outbreak can happen at all. Some people carry the Type 1 or Type 2 herpes virus their whole lives without ever even knowing they have it. But even inactive, the viruses can still be transferable to others.
Treatment for ocular herpes varies based upon the type of herpes it actually is in the eye. Antibiotics used to battle the virus during an outbreak may be prescribed, and for some outbreaks the eye doctor can “scrape” away signs of the virus by sloughing off infected cells in the cornea. Steroids are often used to manage inflammation, but the steroid use has been linked to causing recurrent outbreaks in some patients.
Symptoms of ocular herpes include irritation in the eye, swelling around the eye, the feeling like something is in the eye, watery discharge and tearing of the eye, sensitivity to light, eye redness or infection, and sores in the eye. The cornea can also become cloudy, leading to blurry vision. It’s important to catch the virus in its initial stage to best attack the virus and allow your body a fighting chance at immunity against another outbreak.
There is no cure for ocular herpes, and it is rarer than the other forms of herpes. In America, there is an estimated 500,000 cases of ocular herpes, compared to 25 million individuals with Type 1 (cold sore, fever blister) herpes, and 5 million Type 2 (genital) herpes. While there is no cure for any type of herpes, there are treatments available, both to lessen the severity of an outbreak, and keep the likelihood of another outbreak from occurring in the body.