Herpes of the eye, or ocular herpes, is a recurrent viral infection that is caused by the herpes simplex virus and is the most common infectious cause of corneal blindness in the U.S. Previous studies show that once people develop ocular herpes, they have up to a 50 percent chance of having a recurrence. This second flare-up could come weeks or even years after the initial occurrence.

Ocular herpes can produce a painful sore on the eyelid or surface of the eye and cause inflammation of the cornea. Prompt treatment with anti-viral drugs helps to stop the herpes virus from multiplying and destroying epithelial cells. However, the infection may spread deeper into the cornea and develop into a more severe infection called stromal keratitis, which causes the body's immune system to attack and destroy stromal cells. Stromal keratitis is more difficult to treat than less severe ocular herpes infections. Recurrent episodes of stromal keratitis can cause scarring of the cornea, which can lead to loss of vision and possibly blindness.

Like other herpetic infections, herpes of the eye can be controlled. An estimated 400,000 Americans have had some form of ocular herpes. Each year, nearly 50,000 new and recurring cases are diagnosed in the United States, with the more serious stromal keratitis accounting for about 25 percent. In one large study, researchers found that recurrence rate of ocular herpes was 10 percent within one year, 23 percent within two years, and 63 percent within 20 years. Some factors believed to be associated with recurrence include fever, stress, sunlight, and eye injury.

Herpes Simplex Eye Disease

Herpes simplex is a very common virus affecting the skin, mucous membranes, nervous system, and the eye.  There are two types of herpes simplex.  Type I causes cold sores or fever blisters and may involve the eye.

Nearly everyone is exposed to the virus during childhood.  Herpes simplex is transmitted through bodily fluids, and children are often infected by the saliva of an adult.  The initial infection is usually mild, causing only a sore throat or mouth.  After exposure, herpes simplex usually lies dormant in the nerve that supplies the eye and skin.

Later on, the virus may be reactivated by stress, heat, running a fever, sunlight, hormonal changes, trauma, or certain medications.  It is more likely to recur in people who have diseases that suppress their immune system.  In some cases, the recurrence is triggered repeatedly and becomes a chronic problem.

When the eye is involved, herpes simplex typically affects the eyelids, conjunctiva, and cornea.  Keratitis (swelling caused by the infection), a problem affecting the cornea, is often the first ocular sign of the disease.  In some cases, the infection extends to the middle layers of the cornea, increasing the possibility of permanent scarring.  Some patients develop uveitis, an inflammatory condition that affects other eye tissues.

Signs and Symptoms