Eye Herpes

Medically Reviewed By William C. Lloyd III, MD, FACS
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What is eye herpes?

Eye herpes, or ocular herpes, is a viral infection caused by the herpes simplex virus (HSV). Herpes infections that affect the eye are usually caused by HSV type 1 infections, which are also a common cause of cold sores and blisters on the face, rather than type 2 infections, which affect the genitals. In rare cases, an infant can develop an HSV 2 infection during birth when the mother is infected.

HSV type 1 herpes infections are very common, with approximately 25 million people in the United States being affected each year. Of that population, about 400,000 have had infections in the eye, and about 50,000 will show evidence of an initial infection or flare-up each year (Source: NEI).

Eye herpes most commonly affects the clear outer layer of the eye (cornea). However, it is also possible, although rare, for the herpes infection to affect the inner layers of the eye. Ocular HSV infections only affect one eye, not both.

The cause for the initial development of a type 1 herpes infection is not completely understood, but it is thought that a majority of people are exposed to the virus early in life, with or without symptoms, and that the virus then remains dormant for extended periods of time. The development of symptoms related to the herpes virus signals the activation of the virus; however, not everyone exposed to the herpes virus will develop an outbreak of the typical blister-like sores. The reasons for an outbreak of blisters are not known, although populations with weakened immune systems may be more susceptible to developing outbreaks. Persons who have developed a herpes infection in the eye are at risk for recurrent infections.

Seek prompt medical treatment for a herpes simplex virus (HSV) type 1 infection. Seek immediate medical care (call 911) if you experience other serious symptoms in connection with your herpes symptoms, including sweating, high fever (higher than 101 degrees Fahrenheit), or change in level of consciousness, or if you have sudden blurring of vision or change in vision.

What are the symptoms of eye herpes?

Several common symptoms often occur in an eye herpes infection. If you develop any of these symptoms, you should contact your health care provider to prevent permanent damage to the eye.

Common symptoms of eye herpes

You may experience eye herpes symptoms daily or just once in a while. At times, any of these common symptoms can be severe:

Symptoms that might indicate a serious condition

In some cases, eye herpes can be a serious condition that should be evaluated immediately in an emergency setting. Seek immediate medical care if you, or someone you are with, have any of these serious symptoms including:

  • Fainting, change in level of consciousness, or lethargy
  • Headache
  • High fever (higher than 101 degrees Fahrenheit)
  • Neck stiffness
  • Sudden change in vision, loss of vision, or eye pain

What causes eye herpes?

Eye herpes is caused by infection with the herpes simplex virus (HSV), usually type 1. Symptoms can appear soon after infection or at any later time. It is believed that the majority of the population is exposed to HSV at some point in their life, usually during childhood. However, the virus can remain dormant for extended periods of time. When the virus reactivates, it can cause a herpes outbreak, including possible eye infection.

If you have previously had eye herpes, you are much more likely to develop eye herpes again. The time between episodes of eye herpes can vary from several days to several years.

What are the risk factors for eye herpes?

The reason for reactivation of the herpes simplex virus (HSV) that causes eye herpes is not known. However, if you have previously had eye herpes, several factors may increase your likelihood of a recurrence including:

  • High fever (higher than 101 degrees Fahrenheit)
  • Increased exposure to sun
  • Increased stress levels
  • Injury to the eye

How is eye herpes treated?

Treatment for eye herpes begins with seeking medical care from your health care provider. Eye herpes is typically treated with antiviral eye drops or topical ointments. More severe cases may be treated with steroid drops. Your doctor may also try to remove affected cells manually by brushing them off of your cornea with a cotton swab.

Although the administration of eye drops or ointments is generally effective for the treatment of eye herpes, it does not work in all patients. Left untreated, or if treatment is not effective, severe corneal scarring may result. In some cases, a corneal transplant is required to restore normal vision.

What are the potential complications of eye herpes?

Complications from eye herpes are generally not life threatening, but they can be serious and lead to loss of vision. You can help minimize your risk of serious complications by following the treatment plan you and your health care professional design specifically for you. Complications of eye herpes include:

  • Blurred or double vision
  • Corneal swelling with inflammation and scarring
  • Chronic eye discomfort
  • Loss of vision and blindness
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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2021 Jan 19
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THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.
  1. Ocular herpes. National Eye Institute. http://www.nei.nih.gov/health/cornealdisease/#15
  2. Guess S, Stone DU, Chodosh J. Evidence-based treatment of herpes simplex virus keratitis: a systematic review. Ocul Surf 2007; 5:240.