Determinants of the natural history of recurrent herpes simplex virus (HSV) keratitis have not been consistently established. While these drugs are not high in systemic toxicity, patients often have mild upset stomach or headache upon starting treatment. Type I is the most common and is responsible for herpes simplex eye disease and the familiar “cold sore” or “fever blister.” Type II is responsible for sexually transmitted herpes and rarely causes infection above the waist. Type 2 is responsible for sexually transmitted herpes and rarely causes eye disease. HSV cases had a greater prevalence of atopy (34%, 58/172) than the clinic-based (25%, 43/172) or the population-based controls (21%, 36/172, odds ratio (OR) 1.5, 95% confidence interval (CI) 0.9 to 2.6 and OR 1.9, 95%, CI 1.1 to 3.3, respectively). After time, the infection may spread deeper into the cornea and cause inflammation inside the eye or possibly permanent scarring of the cornea. The initial infection is usually mild, causing only a sore throat or mouth.
Occasionally the virus reactivates and causes a recurrent “cold sore” or “fever blister”. Age, gender, ethnicity, and nonocular herpes were not significantly associated with recurrences, and no seasonal effects were observed. It is not always easy to determine whether simple, acute conjunctivitis is bacterial, viral or allergic. For most people this will be the only episode. The eye turns red and is sensitive to light. The disease usually begins on the surface of the cornea. After an initial outbreak of ocular herpes, there is a 50% chance of having recurrence of the infection.
Some patients develop uveitis, an inflammatory condition that affects other eye tissues. Unfortunately, one out of four people who have a corneal infection is likely to have a recurrence within two years. The process may go deeper into the cornea and cause permanent scarring or inflammation inside the eye. Often, the initial HSV-1 infection of the eye does not produce any significant clinical symptoms and can go unnoticed. While possible, sexual transmission of herpes eye disease is extremely rare. Sexual transmission of herpes eye disease is extremely rare. In people with poor immunity, the herpes simplex virus may infect other parts of the eye or body, such as the retina and brain.
Reprinted with permission of the American Academy of Ophthalmology. It is important to remember that herpes simplex eye disease is not usually caused by HSV type II, the sexually transmitted form of herpes. While possible, sexual transmission of herpes eye disease is extremely rare. Treatment depends on the extent of the disease. While most herpes infections do not cause serious complications, infections in infants and in people with weakened immune systems, or herpes infections that affect the eyes, can be life threatening. At times, it may be necessary to scrape the surface of the cornea, to patch the eye, or to use a variety of medications. In cases of severe scarring and vision loss, a corneal transplant may be required.