Infections
NOV 29, 2010
Question:
Is there a permanent cure for ocular herpes?
Answer:
Ocular herpes cannot be cured, but it can be treated. Herpes zoster is the same virus that causes chickenpox. It can live in nerves for many years in a dormant stage and reactivate when immunity is low or other factors are present. It is very responsive to the three antiviral drugs approved for its treatment, especially if started early. Ocular herpes usually starts with pain around the eye and becomes a skin rash by vesicles (blisters) linearly arranged on one half of the face. It can result in corneal infection and scarring, inflammation, double vision, retinitis, elevated eye pressure and severe pain that persists long after the initial infection clears. Fortunately, there is good treatment today, especially if given early.
The more common herpes infection is caused by herpes simplex virus. Most commonly, this causes characteristic corneal ulcers that can recur and cause swelling and scarring of the cornea and other eye problems. This is the same virus that causes fever blisters and genital herpes, thus it responds to the same drugs. There is also an antiviral eyedrop preparation. In the active acute phase, steroids can make the eye feel better, but actually worsen the disease. Some patients require long-term oral drugs.The virus can live without showing signs of symptoms in the tear (lachrimal) gland. Although 25 percent of initial infections will be self-limited and never recur, even without treatment, a comprehensive ophthalmologist or corneal specialist should manage this disease.