Pink eye herpes virus

Most episodes of active infection are due to a reactivation of the virus at some point, often years after a primary infection. Symptoms include:.

You may also notice a blistery skin rash around the eyelids but not in all cases. It is usually one eye that is affected. Your family doctor will usually examine your eye with a magnifier.

They may also put some stain on the front of your eye. This is used to show up any irregular areas on the transparent front part of the eye. With a herpes simplex infection they will often see a small scratch on the cornea. The typical ulcer which develops is called a dendritic ulcer.

Dendritic means branching. The ulcer is not round with a smooth edge but like a tree with many finger-like branches, as below:. If your doctor suspects a herpes eye infection you will usually be referred urgently to an eye specialist ophthalmologist. A specialist will do a detailed magnified examination of the eye.

This is to confirm the diagnosis and to determine whether the infection is in the top layer of the cornea epithelial keratitis , or if the deeper layers are involved stromal keratitis.

Before you start to use any eye drops or ointment, your eye specialist ophthalmologist may make your eye numb and then gently scrape away some of the infected cells. This procedure is called debridement. Treatment is with antiviral eye ointment or drops such as aciclovir ointment or ganciclovir gel. These do not kill the virus but stop it from multiplying further until the infection clears.

You should take the full course exactly as prescribed. This is often several times a day for up to two weeks. The aim is to prevent damage to the transparent front part of the eye the cornea. Treatment is similar to epithelial keratitis above. In addition to the antiviral eye ointment or drops, your specialist may add in some steroid eye drops. This helps to reduce inflammation. Note : steroid eye drops must only be used under close supervision of an eye specialist. He or she will prescribe the correct strength and dose in conjunction with antiviral treatment.

If you use steroid eye drops wrongly they can make herpes simplex infections worse! These infections will usually settle on their own in weeks. No treatment may be advised. You are likely to be kept under review, until the infection clears, to check that the cornea does not become infected.

Note : if you have herpes simplex eye infection, you should not wear contact lenses until 24 hours after your symptoms and the infection have completely gone away. Some people develop repeated recurring episodes of active infection. Another option is corneal epithelial debridement. Treatment time is about 2. Some people will debride and use a topical agent; some will debride and use an oral agent.

If the keratitis is close to the visual axis and the patient has had more than one episode, Dr. Tuli also uses oral antivirals long term to prevent recurrence. Stromal disease is where the most damage is done. HSV stromal disease. The primary treatment for stromal disease is topical steroids in conjunction with prophylactic oral antivirals. Topical antivirals should never be used long term for prophylaxis because they can cause corneal toxicity, but orals can be used safely for substantial periods of time.

According to Dr. Although Dr. Margolis likes to start the oral antiviral a couple of days before the steroid, he has initiated them simultaneously in cases of stromal disease without ulceration. HSV endotheliitis. Endotheliitis is active virus in the anterior chamber of the eye. Margolis, who treats these patients with oral antivirals because he knows these drugs will get into the anterior chamber. When to use them. Other than that, topical corticosteroids prednisolone acetate 1 percent or prednisolone phosphate 1 percent are essential for treating HSV stromal keratitis.

These agents control inflammation and minimize damage to the eye. You rarely need to use a topical steroid more than four times a day to get stromal disease under control, according to Dr. S-l-o-w-l-y taper the dose. Once inflammation is under control, the goal is to find the minimal effective dose that will keep the eye quiet. Myth: Patients have to get off steroids. Topical steroids should be maintained for as long as necessary. More than 50 percent of her patients remain on microdoses for life.

These patients are also on chronic oral antivirals. After the patient completes a treatment regimen of oral or topical antivirals for seven to 10 days, oral antivirals then serve solely as prophylaxis. Myth: Prophylaxis must be discontinued after one year.

Because HEDS demonstrated the effectiveness of prophylaxis for one year, 4 many believe that it cannot be used for more than a year. Oral acyclovir reduces the severity of stromal disease and the frequency of recurrence for as long as it is maintained. Prophylaxis requires at least mg of acyclovir two or more times a day Table 2.

When to use it. Compliance is excellent because they know the consequences of going off the antiviral. Any patient who is undergoing eye surgery and has a history of HSV should start prophylaxis a few days before surgery and continue it at least until the inflammation has subsided, advised Dr.

Margolis recommends. TODD P. Financial disclosure: None. The ophthalmologist will also conduct a physical examination of the eye. These professionals can usually diagnose eye herpes by looking at the sores. If the infection has reached the deeper layers of the eye, they will need to use special instruments to measure the eye pressure. They will also need to inspect the deeper eye layers whenever possible.

As part of the diagnosis, an ophthalmologist may also take a small cell sample known as a culture from a blistered area. They will then send this sample to a lab for testing for the presence of HSV. For the most part, eye herpes affects the transparent front part of the eye. This condition is known as epithelial keratitis. If eye herpes affects the deeper layers of the cornea, it is known as stromal keratitis.

No cure currently exists for herpetic eye disease. Instead, an eye doctor can prescribe medications that reduce the effects and symptoms of the condition. The location of eye herpes tends to determine the treatment options.

Doctors will prescribe topical ointments, such as an antiviral or antibiotic ointment, for a person to apply gently to their eyelids. While antibiotic ointments will not treat the herpes infection, they will keep other bacteria from entering the open, blistering areas of the eyelid.

If the eye herpes only affects the outermost layers of the eye, a doctor may prescribe an antiviral eye drop or an oral antiviral medication, such as acyclovir Zovirax. These help reduce the effects of the virus and could reduce the duration of symptoms. If the herpes virus has affected deeper layers of the eye, an eye doctor may prescribe antiviral eye drops and oral medications.

They may also prescribe steroid eye drops. These help reduce eye inflammation that could lead to increased eye pressure. As eye herpes can cause further infections, some doctors may recommend taking antiviral medicines on a regular basis to reduce the risk of getting eye herpes again.

Recurrent herpetic eye infections can lead to greater eye damage, which is why doctors want to prevent their recurrence. Doctors may recommend that a person take an antiviral medication a few days before they have surgery so that they can prevent the stress of the surgery from triggering a herpes outbreak. According to the American Academy of Ophthalmology, doctors diagnose about 50, new cases of eye herpes each year in the United States. While there is no cure for eye herpes, treatment can reduce the duration of symptoms.