By Published On: 25 April 20123.5 min read

There are two types of the basic  Herpes Simplex Virus, or HSV:

•    Type 1 – this is the one that produces cold sores or blistering on the lips and is thought to be contracted at an early age from kissing on the mouth by family members who have the dormant virus.

In a funny way it’s good that the eye version of herpes comes from this Type 1 Herpes as symptoms and treatments are easy to deal with.

•    Type 2 – this is the one that affect the genital area and although eye infection can be contracted from it, as in the case of mothers passing it on through the eyes to her baby whilst giving birth, instances are relatively rare.

So what is Herpes?

The jury is out on what Herpes really is, but most people are exposed to the virus in early years and either contract it or not – and if they do contract it the virus lays dormant ready to spring into life again.

The cold sore blisters associated with the herpes seem to come out of nowhere on the oddest occasion, although they do often accompany winter colds.

It’s not considered worthwhile visiting the doctor for such a minor ailment, but dentists see quite a few cases of course in their line of work, and they offer an effective preventative remedy:-

“At the very earliest onset of the very slightest tingly feeling, which is the first sign of a cold sore, as soon as you can – meaning as soon as you can! – hold an ice cube on it for as long as you can stand the pain”

People who have used this remedy say it really works.

Another more proven treatment is to use Zovirax ointment (Acyclovir).  This is available in ointment form over the counter for cold sores and is the main line of treatment for epithelial herpetic keratitis of the eye.  The eye ointment requires a prescription by a therapeutically qualified optometrist or ophthalmologist.

Occasionally herpes cold sores are recurrent. In this case preventative oral Acyclovir has been shown to reduce recurrence.

Ocular (Eye) Herpes

Of the millions of people who get herpes cold sores every year only about 2% will go on to get an eye herpes infection, and whilst with a cold sore it’s just a case of waiting it out, with the eye version it’s best to consult an eye-care professional such as an optometrist.

There are several variations of eye herpes that need anything from mild attention to serious treatment to prevent serious vision loss:

•    Epithelial Keratitis – this is the commonest form of eye herpes and affects the top layer of the cornea. A course of eye drops is usually sufficient to clear it up.

•    Stromal Keratitis – affects the deeper part of the cornea and so steroid eye drops are often prescribed, but only under strict supervision of a therapeutically qualified optometrist to ensure there will be no loss of vision.

•    Herpetic Uveitis – a particular type of uveitis caused by herpes and sometimes present with keratitis. Uveitis is an inflammation of the inside of the eye called the uvea.

•    Herpetic Retinitis – in this case the herpes virus infects the rear of the eye in the retina.

Symptoms

Symptoms include those exhibited in many diseases and disorders of the eye and it takes an experienced eye-care professional to detect the condition:

•    Sensitivity to light

•    Bumps on the eyelid

•    Pain in or around the eyes

•    Red or “pink” eye, typically seen with conjunctivitis

•    Vision becoming gradually blurred

Causes and Prevention

Knowing the causes of Eye Herpes can help in those contracting the condition from having too many recurrences:

  • Mainly due to contact with another person with the condition
  • Too much sun
  • Stress!
  • Too much rubbing of  the eyes
  • Eye strain, particularly from over use of computers – this one is controversial.

Sometimes Eye Herpes becomes recurrent and the only way to try and reduce recurrences is with the use of oral Acyclovir.  It is a relatively benign drug with few side effects.  This is best prescribed by a corneal specialist, as recurrent herpes in the eye can lead to blindness if not treated promptly.

Comments

65 Comments

  1. zak parsonage 3 March 2013 at 9:50 am - Reply

    hi ive just read this article and would like to ask a few questions.
    i contracted the herpes virus in my right eye when i was approximatley 6 months old i have regular reacurrences and flare ups i have been going to my local royal eye infermary since i was about 6 months old aswell i am now 24.
    my vison in my right eye has gradually got worse and more blurred in the last 3-4 years and im not sure if my eye infermary are doing enough to help as i keep getting the same treatments and answers and it doesnt seem to be getting any beter i think i have less then 30% vision now and its effecting my judging of distance it really effects my day to day work and could also be quite dangerous. i am worried that eventually i will go blind completley, i was wondering if there is any sort of treatment to help with the blurred vison or operations i am willing to try absolute anything!!i was an aspiring and a very good boxer but couldnt continue with it due to my condition please could you contact me with any information or details thank you very much for taking the time to read my email

    regards zak parsonage

  2. Kendra 9 November 2013 at 4:37 am - Reply

    I was just wondering how long this takes to go away and will I have this come up all the time for the rest of my life.

  3. Nic 17 April 2014 at 12:27 pm - Reply

    Hi, my 2 year old daughter has contracted mouth herpes and i noticed a couple days ago her eyes were red and sore looking and she was complaining about bright light. They weren’t particularly watery and there was no puss like usually seen in conjunctivitis. Just wondering if it is worth getting her checked with such subtle symptoms?

  4. samantha marshall 23 May 2014 at 9:16 pm - Reply

    Hi my 6 year old daughter has sufferd with this virus in her eyes since she was 3 she as been given Acyclovir oral medicine wich she takes twice daily 7am 7pm they have givin her glasses and an eye patch she as scaring in central of her cornea she is under a consultant at the uhns hospital but for the the past 8 days her eye as been bright red and sore to touch i dont no if to call hospital or what to do as i dnt want to waste there tie if its nothing ttanks samantha

  5. raika 19 July 2014 at 7:04 am - Reply

    hi,
    i want to know is there any way to get back the sight of a blind person with ocular herpes?
    my friend is 34 yeras old, he was child got ocular herpes and one of his eyes got wors by the years now one of his eyes is blind and another one has a bad sight. drs say if we treat it might be blind both of them is it true? what should we do?

  6. Valerie 2 January 2016 at 7:52 am - Reply

    Hello,Dr Jim,can you please tell me what else i can do for eye herpes.Virgan gel 5 x daily,also the best Dr to help.
    Regards from Greece.

  7. Christina 27 March 2016 at 9:38 pm - Reply

    Hi..
    I have extreme blurriness I’m my eye and my optometrist said I have herpes symplex and it has not went away I’m taking erythromycin ointment and aryclovior pills that the er prescribe me I’m very scared because I don’t want to go blind. .. is there a possibility that this will clear up I’m 21 weeks pregnant

  8. Jackie 10 May 2016 at 12:23 pm - Reply

    Thanks for the informative article. I have detailed my questions in your contact us section and hope to hear a reply soon. My child has had HSV around his eye multiple times and as it may affect vision am very concerned and would love more information regarding ocular herpes in children. Thanks

  9. Gina 2 June 2016 at 8:47 pm - Reply

    Hi, I’ve had herpes 1 for many years and typically have flare ups on my mouth when I am run down or stressed.

    I have recently had flu and I am sure not helped by running my eyes, I have developed herpes on one eyelid. From what I have read above it doesn’t seem like ocular herpes as it doesn’t effect my eye at all. It is the outdid lid that is sore and bumpy and about to blister.

    I’d like to apply acyclovir to the skin on my eyelid and of course avoid my eye, but am concerned if the acyclovir itself could be harmful if absorbed around my eyelid, or if having heroes on my eyelid is more serious and can effect my eye?

  10. Lee 8 June 2016 at 11:11 pm - Reply

    Hello, I have just been diagnosed with a case of this and I am taking oral acyclovir and drops, but the swelling in my eye is getting worse and the drops I put in seem to not be absorbed and are running out the sides of my eye. I also keep getting very sharp pains in my infected eye as well. Is all of this normal?

  11. Debbie 24 July 2016 at 5:40 pm - Reply

    Hi, my husband was prescribed numbing drops by an ER DR. Those drops burned his cornea. Now he has contracted herpes on top of that. His eye looks like hamburger meat. The cornea is all “chewed” up. This began on the 8th, it is now the 24th. He is still in nonstop excruciating pain. Migraines. He can’t do anything but sit in a recliner…..he is so light sensitive he can’t go outside. He is wearing 2 pair of sunglasses. He is being seen by a cornea specialist. There has been zero improvement. The Dr. Says it could be weeks of pain like this. Should we seek a second opinion…..oh I forgot to mention, he has nearly zero vision in that eye as well. He can only see a shadow of a hand moving just inches from his face. That happened after 2 days of using the numbing drops as needed for pain, per the ER DR.

  12. Letitia 8 November 2016 at 4:34 am - Reply

    Hi, just recently, my right eyelid has become swollen and very sore. The lid has also developed a small group of bumps. It started out as only being sore, with a stinging sensation but gradually worsened over the last couple of days.

    I have had a similar situation with the same eyelid two years ago but there were two tiny dots that looked to almost look like spider bites. Could I possibly have eye herpes or could this be a flare up from the previous occasion?

  13. Haydon 22 November 2016 at 2:12 pm - Reply

    I recently had cataract surgery on both eyes results were good to stsrt with for a few weeks now the are very sore could i have eye herpes as i suffer from genital herpes

  14. Bo 10 December 2016 at 6:56 am - Reply

    Hi there,
    I have recently contracted oral herpes with some scarring on the cornea. I have been an avid surfer all my life and it is also my livelihood. I have used contact lenses most of my life and really can not surf without them. Will I be able to wear contacts again and how progressive is the disease please. Thankyou

  15. Wendy Oglesby 20 December 2016 at 5:06 pm - Reply

    I have had keratitis of the eye since I was 6 mo old I am now 40 yes old’ daily I take 500 mg of Valtrex as a maintenance med & if have a flare they up that to 1 gram a day’ 8 also take Predinisole suspension drops when my eye is irritated whenever I choose’ and if I have a full on corneal blister then I take the 1 gram of Valtrex the suspension drops & acyclovir (opthamalic) as well’ I have had multiple surgeries as a child in the 70’s on this EYE & the vision is blurred only color distinctions nothing else’ & it’s been that way my entire life’ maintenance meds help tremendously daily! Non-stop!

  16. Tammie 31 December 2016 at 11:37 pm - Reply

    I always get a herpetic breakout after Christmas. This time I could feel it in my left eye. I only have the Zovriax cream (prescription) My skin looks alot better but my eye is hurting. I went to a weekend clinic who absolutely did zero for me! I explained to this newbie nurse practitioner that I needed the oral pill form now until I could see my doctor or a specialist. I told her to check my chart on what my doctor has done in past. She refused! It’s New Year’s eve folks. She said NO to acylovir pills and for me to go to E/R. I told her NO mainly because they will not have a OPthalmologist E/R doctor especially on New Year’s. She felt more than comfortable to just let me go untreated knowing this. I just read above story on man going blind over numbing drops in E/R. NO THANKS! I’ll just use my cream, take 500mg of Lysine 3 times a day until I can call my doctor on Monday. What a LOSER she was!

  17. Shawn 12 January 2017 at 2:10 am - Reply

    Is it possible just to get HSV on the eyelid and not in the eye itself.i just found out my daughter has it and I am so scared.They gave me the valtrex oral to clear up her skin and it’s doing a good job I am just worried.

  18. Louis 26 January 2017 at 6:55 am - Reply

    My 6 year old got a cold soar, which started spreading. Now his eyes are red, and swollen . Do you think he spreaded the virus to his eyes?

  19. Shan 2 June 2017 at 9:03 am - Reply

    Hi there,
    My one eye recently got super itchy and irritated one morning. I rubbed it as it was itchy. I pulled down my lower eyelid and notice a few little bumps on the INSIDE of my lower eyelid. Could this be eye herpes? I went to the dr and he said it’s an allergy reaction and bumps are common with an allergy in the eye but I’m still very worried about it.

    • Jim Kokkinakis 6 July 2017 at 2:25 pm - Reply

      This is not herpes. Your Dr is probably correct. A cold compress or some eye drops called Zaditen often help.

  20. Taylor 20 July 2017 at 11:59 am - Reply

    My name is Taylor….since this last sunday I started to notice my sores inside my mouth and my mouth starting tingling and itching and I felt very sick with a headache and underneath my neck was aching…then I started to itch all over and sores began forming on my face and down there I thought it was just acne so I picked at it and touched it and also rubbed both of my eyes…now my eyes are aching and I can’t see as well as I used to and I noticed small sores on the inside of both of my eyelids and outside near my eyes…I went to the eye doctor and told them everything they checked my eyes and just said they couldn’t see anything and nothing was wrong and they gave me eye drops for dry eyes…I have used the eye drops the way they told me to and I have not gotten better I have throbbing pain in both my eyes and head my vision is getting is worse and when I look in the mirror I can see red branchs forming on my eyes and the sores are still there….what should I do?😞😞😞😞

    • Jim Kokkinakis 25 July 2017 at 11:48 am - Reply

      Taylor you need to see your GP ASAP. Its probably a virus but this could be serious as well, so trying to sort it our over the internet is not appropriate.

  21. BetterYours 17 August 2017 at 6:50 pm - Reply

    Hey can advice for my case here?

    I’m having oral herpes here. Can i get to know the possibilities having ocular herpes without any self contact with the sores or virus?

    My eyes having minor sensation. Like dry eye with minor pain. Plus having severe headache. Checked with eye specialist but they said I’m fine.

    • Jim Kokkinakis 17 September 2017 at 9:22 am - Reply

      Without seeing your eyes it is hard to give definite answers but I would agree with your specialist. Many people have oral herpes, but usually do not get eye herpes. Dry irritated eyes in todays digital world is an epidemic, so by all probability you have dry eyes. See the following link for more information on Dry Eyes.

  22. Frances 24 December 2017 at 2:27 am - Reply

    Hello, I was just diagnosed with genital herpes after receiving oral sex soon after my partner had a cold sore. I am taking oral acyclovir but noticed slight eyelid swelling and discharge this morning in one eye. I have been extremely careful about washing my hands since the diagnosis yesterday, but am afraid it could have already spread. How can I prevent any conjunctivitis outbreak? It’s Christmas weekend and I’m traveling.

    • Jim Kokkinakis 28 December 2017 at 3:35 pm - Reply

      Frances it is unlikely that this is a herpetic eye infection. It has been a number of days now, how is the eye at the moment.

  23. Deb 20 January 2018 at 9:43 am - Reply

    Hi, I currently had a widespread outbreak of oral herpes which inevitably led to my eyelids, and now one eyelid is “crusty” and surrounded by blisters which appear to be filled with puss. Is this a normal symptom of ocular herpes? I recently saw an optometrist who said my eyes and cornea themselves were fine and i was prescribed with eye drops and ointment I’m applying every two hours for the next 24 hours. I’m seeing a little bit of improvement, but my eyelids are still painful and blistered. I’ve had this for almost a week and I’ve seen my GP a couple of times, at what point should I consider this to be a medical emergency, if I should consider it as such? I’m a little worried about vision loss and considering the ER if it doesn’t improve by at least a few more days, is this reasonable? Thank you for your time!

    • Jim Kokkinakis 22 February 2018 at 10:35 am - Reply

      This is best managed by an ophthalmologist who specialises in the anterior segment

  24. Tara 27 March 2018 at 2:57 am - Reply

    My son who is 14 contracted ocular herpes as a result of a boy in his class with cold sores he was picking at. Then of course they’re all using the same machines and being a dusty environment it didn’t surprise me. I’m posting here because we got the diagnosis the beginning of December 2017 and it’s been an uphill battle ever since. Our last appointment was with an ophthalmologist who said “this is beyond my expertise”. He was 5th doctor we had seen. Every time we lower the dose of the acyclovir his eye flares up. He can’t stay on the higher dose because it’s showing to be negatively affecting his liver. We are now being sent to an infectious disease specialist for Dr. #6. My question is has anyone ever face a case of ocular herpes that didn’t respond to treatment? Have you come across anything that worked? He already has scar tissue and vision loss from the repeated outbreaks and he’s missed nearly 3 months of school. Any help or advice would be greatly appreciated.

    • Jim Kokkinakis 11 April 2018 at 2:38 pm - Reply

      Tara this is indeed distressing. Typically this type of problem only will affect one eye. Even though this is bad in enough it is unlikely that the other will be affected. There are other antivirals that can be tried, but this is very specialised and must be in the hands of a corneal specialist that has extensive experience with ocular herpes.

  25. Angel Bentil 20 June 2018 at 8:45 am - Reply

    I’ve just been diagnosed with hsv1 3 weeks ago and I’ve been very careful to not touch my eye or face as much however my eyes today have had red viens in only the left side of my right eye. It felt itchy earlier and I rubbed it thinking nothing of it and noticed about 2 hours later the redness. My eye is still itchy though I’m avoiding rubbing. it doesn’t hurt and I’m just worried this is the start of ocular herpes and that I spread it from my cold sore. How long do your eyes stay red with ocular herpes?

    • Jim Kokkinakis 22 August 2018 at 1:53 pm - Reply

      The eyes tend to stay red for around 2 weeks. Ideally I would try and get some acyclovir ointment to put in them. This will stop the herpetic infection from replicating.

  26. Andrew 8 July 2018 at 3:17 am - Reply

    Hello
    For the past few months i have been taking Valacyclovir for a strain of ocular herpes. It has cleared up and i have been taking a 1g pill daily for about 2 months now. Just today, my eye has flared up again. My doctor told me to just take 3 pills everyday if it were to flare up again, but he said it was unlikely. I guess my question is, if i am taking the 1 pill daily, why would it flare up again?

    • Jim Kokkinakis 22 August 2018 at 1:58 pm - Reply

      Everyone is different and one pill might do the job for one patient, yet maybe two is required for the next. This tends to be trial and error.

  27. margaret davies 23 July 2019 at 5:09 am - Reply

    My son is 43 years old. He is nearly blind. A specialist did a cornea operation years ago. It did not work. Will glasses help his sight? Will an eye transplant help him? Is there any fundraising done to help find an answer to this problem.

    • Jim Kokkinakis 3 May 2020 at 3:23 pm - Reply

      At this stage eye transplant do not exist. I assume this has only infected one eye as it is not common to have a herpetic cornea infection in both eyes. To be sure someone that specialises in this area will advise. The cornea specialist is the first person to ask, as he is familiar with the intricacies of your son’s case.

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