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.

49 Comments

  • by BetterYours Posted August 17, 2017 6:50 pm

    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.

    • by Jim Kokkinakis Posted September 17, 2017 9:22 am

      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.

  • by Taylor Posted July 20, 2017 11:59 am

    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?😞😞😞😞

    • by Jim Kokkinakis Posted July 25, 2017 11:48 am

      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.

  • by Shan Posted June 2, 2017 9:03 am

    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.

    • by Jim Kokkinakis Posted July 6, 2017 2:25 pm

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

  • by Louis Posted January 26, 2017 6:55 am

    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?

    • by admin Posted February 26, 2017 5:53 am

      Louis I suspect the eyes now are clear. It is important now to see a corneal specialist if a flare up occurs again.

  • by Shawn Posted January 12, 2017 2:10 am

    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.

    • by admin Posted February 26, 2017 5:50 am

      Yes it is more common on the eyelids. If she has taken Valtrex I wouldnt worry.

      • by Tonya Posted July 4, 2017 9:05 am

        I have been experiencing pain in one eye, bump on eye lid, pain around the eye and redness. I had an eye exam 3 days again and the optometrist says my eyes are healthy and didn’t have any problems but I m still concerned. Is it possible he missed something or should I have further testing??

        • by Jim Kokkinakis Posted July 6, 2017 2:33 pm

          See how this settles over the next week or so. if it is no better tell me where you are from and I can recommend someone close to you.

  • by Tammie Posted December 31, 2016 11:37 pm

    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!

    • by admin Posted January 2, 2017 7:15 am

      Tammie what’s sad about this is that there is little harm in giving someone with a previous history of herpetic eye disease. A nurse practitioner is given a lot of responsibility. They will get no recognition for doing something right, but will get crucified if something goes wrong. They therefore are very defensive in how they prescribe. The other issue is that their knowledge of eye disease is very very limited.

  • by Wendy Oglesby Posted December 20, 2016 5:06 pm

    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!

    • by admin Posted December 30, 2016 5:04 am

      Thanks for your feedback Wendy. Herpetic keratitis usually on affects one eye luckily. Oral antivirals like Valtrex are extremely beneficial in the long term to inhibit flare ups.

  • by Bo Posted December 10, 2016 6:56 am

    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

    • by admin Posted December 30, 2016 5:15 am

      Hi Beau
      Unfortunately surfing and being in the sun is a risk factor for reactivation of both oral and corneal herpes. Of course everyone is unique so I can only make generalisations. If you are prepared to take the risk and insist on continuing your surfing, then I would recommend the following:
      1. Wear scleral contact lenses. These are custom made and are expensive, but they will protect your eyes the most.
      2. Maybe even go to the rouble of wearing surfing goggles with a tint in them.

  • by Haydon Posted November 22, 2016 2:12 pm

    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

    • by admin Posted November 27, 2016 8:43 pm

      Sounds like dry inflamed eyes. Does not sound like eye herpes.

  • by Letitia Posted November 8, 2016 4:34 am

    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?

    • by admin Posted November 27, 2016 8:44 pm

      Hard to diagnose this without seeing you. I would see a therapeutic optometrist or an ophthalmologist.

  • by Debbie Posted July 24, 2016 5:40 pm

    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.

    • by admin Posted July 26, 2016 10:22 am

      Debbie
      This is horrific. An ER doctor is under a lot of pressure to make decisions quickly. In hind sight it would have been better to see an optometrist or an ophthalmologist. I would definitely get a second opinion. More than two weeks in such a state, might need a differnet approach.

  • by Lee Posted June 8, 2016 11:11 pm

    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?

    • by Jim Posted August 18, 2016 3:52 am

      Depending on how long you have been taking the medication. I would suspect if it is not getting better after a week, you need another consultation by a corneal specialist.

    • by Myrtha Reyes Posted November 23, 2016 9:35 am

      Hi!
      I have this problems for more than 30 years, The ointment works, but before it gets better, it feels like is getting worse, is a typical pattern of recovery.
      Some times Doctor gives me steroid drops to ascelerate the recovery.
      I hope this help you

      • by admin Posted November 27, 2016 8:42 pm

        This sounds very typical.

  • by Gina Posted June 2, 2016 8:47 pm

    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?

    • by admin Posted July 26, 2016 10:24 am

      Gina you can apply acyclovir ointment to the eye lids and even in the eye. It is best to get the ophthalmic quality version which is more pure than the one that is used on the lips.

  • by Jackie Posted May 10, 2016 12:23 pm

    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

    • by Jim Posted May 12, 2016 10:27 am

      Dear Jackie
      Thank you for contacting us. I hope we have been able to direct you into a better space for this very scary condition. Especially when it comes to our children.

    • by Anne Posted July 5, 2016 6:54 pm

      My son is 11 and has that around eye as well. Maybe we could connect with each other?

  • by Christina Posted March 27, 2016 9:38 pm

    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

    • by Jim Posted March 30, 2016 6:47 am

      Hi Christina of course there is a possibility this will clear, but I would recommend a second opinion. Where are you located?

  • by Valerie Posted January 2, 2016 7:52 am

    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.

    • by Jim Posted March 30, 2016 6:37 am

      Hi Valerie
      You can also use acyclovir oral tablets. You need to see a corneal surgeon. Greece has many well trained ophthalmolgists, but make sure they are corneal trained.
      More on herpes eye disease can be found on my blog:

  • by raika Posted July 19, 2014 7:04 am

    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?

    • by admin Posted July 30, 2014 4:32 am

      Ocular herpes can have devastating effects but usually only in one eye. each case is unique to the individual so without seeing your friend it is impossible to know what can and cannot be done. Any surgery on an eye with ocular herpes is usually unsuccessful in the long term. There is a small (very small) possibility that both eyes could become blind but I think the main issue is that surgery is rarely successful to the operated eye. The next question becomes what is the diagnosis of the other eye? Is it ocular herpes or is it something else (which is usually the case).
      Regards
      Dr Jim Kokkinakis

  • by samantha marshall Posted May 23, 2014 9:16 pm

    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

    • by admin Posted June 26, 2014 7:39 am

      Dear samantha
      i am sorry for the late reply. I was away for most of may and was not able to answer questions on my websites.
      By now you will have done something about this, but any time this happens it is important to seek a consultation immediately as more than likely there is a flare up and without aggressive treatment further scarring will occur.
      Regards
      Jim

  • by Nic Posted April 17, 2014 12:27 pm

    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?

    • by admin Posted April 17, 2014 11:27 pm

      Hi Nic
      Herpetic infection as a baby occurs to the majority of the population. It is possible that the infection has spread into the eyes. It is a good idea to see a therapeutic optometrist that can prescribe ophthalmic acyclovir ointment.
      Regards
      Dr Jim Kokkinakis

    • by Eva Posted December 5, 2015 4:32 pm

      How did your daughter contract mouth herpes?

      • by admin Posted December 30, 2015 11:45 pm

        This occurs usually by kissing babies. Remember that around 90% of the population has herpes dormant in their system.

  • by Kendra Posted November 9, 2013 4:37 am

    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.

    • by Jim Posted December 25, 2013 10:42 pm

      Hi Kendra. Herpetic infection in the eye can keep coming back, but is very individual. The key is to make sure you have a good optometrist that is therapeutically qualified to monitor you. Any sign of flare up needs managing immediately. Often taking oral anti virals like Famvir is prescribed to keep things quiet.

  • by zak parsonage Posted March 3, 2013 9:50 am

    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

    • by Jim Posted March 3, 2013 10:16 am

      Hi Zak
      Where are you from? Recognized treatment for recurrent herpetic disease is taking oral (in tablet form) Acyclovir or Famvir (they are similar drugs). These must be taken for ever. As far as surgery is concerned your only possibility is a corneal transplant. This type of procedure is often not successful due to recurrence of the herpes. A contact sport after a corneal transplant is not possible due to the possibility of rupturing your eye from a punch or a finger in the eye eg. wrestling.

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