Herpes in eye photos: The request could not be satisfied


What Are the Different Types of Canker Sores?

What exactly are canker sores, and what are the different types? What are the symptoms, causes, and treatments?

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Canker sores, also known as aphthous ulcers or aphthous stomatitis, are small lesions (sores) that occur inside of the mouth. The exact cause is unknown but they are not contagious.

Roughly 20% of people will develop canker sores at some time in their life, and the condition appears to run in families. Canker sores do not develop on the external surfaces of the lips and are not to be confused with cold sores.

Types of Canker Sores

Not all canker sores are alike. Canker sores may be classified as minor, major, or herpetiform.


Although painful, minor canker sores are often fully healed within two weeks after onset. The size of a minor canker sore varies but typically stays under 1/3 inch to 1/2 inch. Minor canker sores may also be referred to as “simple” canker sores. The relative incidence of this type of sore is 80%.


Canker sores that appear larger than 1/3 inch to 1/2 inch, usually last longer than two weeks, and appear to have irregular, oddly-shaped margins. Rarely, this type of canker sore may leave behind a scar.

Major canker sores are common in people who are immunosuppressed due to chemotherapy or a condition such as HIV/AIDS. Major canker sores may also be referred to as “complex” canker sores. These account for 15% of canker sores.

Herpetiform Canker Sores

As a cluster of several (often dozens) of tiny lesions that appear to form one larger sore, herpetiform canker sores may last from one week to one month. These represent 5% of canker sores.

Canker Sore Symptoms

Canker sores appear inside of the mouth as round or oval sores typically with a red border and yellow, gray, or white center. Canker sores typically develop:

  • On the top surface of the tongue and the tip of the tongue
  • Underneath the tongue, on the floor of the mouth
  • The inside of the cheek and lip
  • On the gum tissue

One to two days before appearing visually, a burning or tingling sensation may be present in the area of your mouth where the lesion is developing. Rarely, a fever might be present when developing a canker sore.

Canker sores may become quite painful, especially when eating, drinking, and talking.


While we don’t know exactly what causes canker sores, several risk factors have been identified. Any form of trauma to the mouth, from sports injuries, to eating hot food, and even some ingredients in toothpaste may result in canker sores. Canker sores are also more common in people with certain vitamin deficiencies or who are immunosuppressed.


Canker sores do not necessarily need to be treated, and even if they do, they may respond to simple at-home remedies such as a saltwater and sodium bicarbonate solution. When severe, prescription medications may be needed.

It is recommended that you seek treatment from your dentist if you have recurrent canker sores and/or canker sores that do not heal after 14 days.

One of the best ways to avoid canker sores is to treat the underlying causes. Improperly fitting dentures or broken teeth should be repaired. If it is hot or spicy food, or even gluten in food if you have celiac disease, making dietary changes may help.

Even stress management techniques may be of some benefit as stress appears to trigger canker sores for some people. Some potential causes are unavoidable, but you may wish to talk to your doctor if you are experiencing recurrent canker sores related to a medical condition.

Frequently Asked Questions

How do you treat a major canker sore?

If your canker sore is large and painful, your doctor may prescribe an antibacterial mouth rinse or a corticosteroid ointment. Over-the-counter oral pain gels are also available to help ease symptoms.

How long does it take a major canker sore to heal?

Major canker sores can take between four and six weeks to heal. They may also leave a scar.

A Word From Verywell

Canker sores can be uncomfortable and make it difficult to eat, or even talk. There are different types of canker sores, which are in turn related to different risk factors. Most of the time canker sores do not need to be treated, but home remedies, as well as prescription treatments, are available if needed.

Information about Herpes Eye Disease and Other Herpes Viruses Including Chickenpox

Introduction to Herpes Viruses and the Eyes

Most people are surprised to find out that two types of herpes viruses — the one that causes cold sores and the one that causes chickenpox — can cause a condition called herpetic eye disease. Unlike a separate virus that causes genital herpes, herpetic eye disease is not sexually transmitted.

One of the viruses that causes herpetic eye disease is called the varicella-zoster virus. It is the same virus that causes chickenpox and shingles. When this virus affects the eye, it is called herpes zoster ophthalmicus.

The other virus that causes herpetic eye disease is called herpes simplex type 1. Herpes simplex type 1 is the same virus that causes cold sores on the lips and mouth. In the eye, it usually causes an infection of the cornea. This infection is called herpes simplex keratitis.

How Does Herpetic Eye Disease Develop?

Like many viruses, the herpes simplex 1 and varicella-zoster viruses are present in most adults. The viruses in the herpes family usually live around the nerve fibers in humans without ever causing a problem. Occasionally, the viruses will start to multiply, or they will move from one area of the body to another, and that is when herpetic disease breaks out. This often happens when the immune system of the body is weakened by some other health problem.

How Is Herpetic Eye Disease Diagnosed?

The two types of herpetic eye disease have different symptoms. One thing they have in common, however, is that they can both be very painful, because they affect the nerves directly. The problem is likely to be herpes zoster ophthalmicus if your doctor finds some or all of these symptoms:

  • Pain in and around only one eye
  • Headache and fever
  • Redness, rash, or sores on the eyelids and around the eyes, especially on the forehead
  • A rash on the tip of the nose
  • Redness of the eye
  • Blurry vision
  • Swelling and cloudiness of the cornea

The problem is likely to be herpes simplex keratitis if your doctor sees these symptoms:

  • Pain in and around only one eye
  • Redness of the eye
  • Feeling of dirt or “grit” in the eye
  • Overflowing tears
  • Pain when looking at bright light
  • Swelling or cloudiness of the cornea

Your doctor might want to use special tests if it looks like herpetic eye disease might be present. The pressure inside the eye will probably be checked, for example. There is also a special dye called fluorescein that the doctor might put into the eye. This dye glows under ultraviolet light and will show the doctor if the virus is causing problems on the surface of the eye.

How Is Herpes Zoster Ophthalmicus Treated?

Because herpes is a virus, antibiotics such as penicillin are not an effective treatment. The only drugs that will work against herpes infections are antiviral medications.

Your doctor will likely recommend antiviral pills to quicken healing and decrease the severity of the condition. It is important to keep using the medicine for as long as your doctor recommends. Even though the eye might start to look or feel better, the infection could come back if you stop taking your medicine too soon.

If the infection is affecting the cornea, eye drops called corticosteroids might also be recommended. Corticosteroids will help control the disease, but they can also raise the pressure in the eyes of some people. If corticosteroids are being used, it is important for the patient to come back to the doctor’s office so the pressure can be checked.

Another type of eye drop might also be prescribed to keep the pupil dilated. This will help the eye’s natural fluids flow, which prevents the pressure from increasing.

Unfortunately, herpetic eye disease can be painful even after several days of treatment and even when the eye is starting to look better. This can be discouraging, but it does not mean that the treatment is a failure. The medications are working, and the pain will go away eventually.

How Is Herpes Simplex Keratitis Treated?

The same types of eye drops and pills that are used to treat herpes zoster ophthalmicus are often prescribed to treat herpes simplex keratitis. It is also just as important to use the medications as recommended and to keep all appointments with your doctor.

Herpes simplex eye infections – NHS

Herpes simplex eye infections are a potentially serious type of eye infection.

They’re caused by a virus called herpes simplex – usually the herpes simplex virus type 1 (HSV-1), which also causes cold sores.

It’s important to get medical help if you think you may have the infection, as your vision could be at risk if it’s not treated.

Symptoms of a herpes simplex eye infection

Symptoms of a herpes simplex eye infection can include a red eye and swelling around the eye


Symptoms of a herpes simplex eye infection can include:

  • a red eye 
  • eye pain
  • swelling around the eye
  • sensitivity to bright light
  • a watering eye
  • blurred vision

Usually only 1 eye is affected.

Where to get medical help

Get medical help as soon as possible if you have these symptoms. They could be caused by a herpes simplex infection or another eye condition that needs to be treated quickly.

If it’s not treated, there’s a chance your vision could be affected.

You can get help and advice from:

If you wear contact lenses, take them out and do not use them again until you’re advised by a medical professional that it is safe to do so.

Treatments for herpes simplex eye infections

Most herpes simplex eye infections get better in 1 to 2 weeks, although they can last longer. Treatment is usually needed to reduce the risk of complications.

The main treatments are:

  • antiviral eyedrops or ointment – these stop the virus spreading and are usually used several times a day for up to 2 weeks
  • steroid eyedrops – these may be used in combination with antiviral drops (under supervision by an ophthalmologist) to reduce inflammation
  • antiviral tablets – these are occasionally needed to treat more severe infections and afterwards to stop them coming back

Make sure you follow the advice you’re given and take any prescribed treatment as directed. It’s important to complete the recommended course of any medicine even if your symptoms go away. This will help stop the virus coming back.

Causes of herpes simplex eye infections

Herpes simplex eye infections usually occur when a previous infection with the virus reactivates and spreads to the eye.

Nearly everyone is exposed to the herpes simplex virus during childhood. Most people will not notice this because there are often no symptoms. But afterwards the virus will remain inactive in the body.

In some people, the virus can be reactivated later on. This can happen randomly or may be triggered by:

  • an illness or a high temperature
  • exposure to strong sunlight or cold wind
  • an eye injury
  • stress
  • periods 
  • having a weakened immune system – for example, if you have chemotherapy

Possible complications

Herpes simplex eye infections do not usually cause further problems if they’re treated promptly, but about 1 in 4 cases are more serious and carry a higher risk of complications.

These can include:

  • scarring of your cornea (the front of your eye) – this can cause permanent blurred vision and may require a cornea transplant
  • a further eye infection caused by bacteria or fungi
  • glaucoma (where the optic nerve, which connects your eye to your brain, becomes damaged)
  • permanent vision loss – although the vast majority of people will not experience any significant loss of vision

It’s also likely the infection will return at some point. Most people will experience more than 1 infection, with about 1 in 5 having a recurrence within a year.

Page last reviewed: 11 November 2019
Next review due: 11 November 2022

Eye Herpes – Symptoms, Causes, Treatments

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:

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.

Herpes Simplex Keratitis (HSK)







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Herpes simplex virus (HSV) infection is extremely common, though usually latent

  • up to 90% of UK population is seropositive for HSV

HSV-1 generally infects ‘above the waist’ (lips, face, eyes)

  • primary infection usually in childhood, then virus lies dormant in trigeminal ganglion
  • when virus reactivates it travels along branches of the trigeminal nerve to cause local infection (e. g. cold sore or herpes keratitis)

HSV-2 generally infects ‘below the waist’ and is usually sexually acquired

  • but may also be a cause of herpetic keratitis

Ocular HSV infection (of which the incidence of new cases is 5-15 per 100,000 per annum) can manifest as blepharoconjunctivitis, keratitis, anterior uveitis or acute retinal necrosis. The most common form is epithelial keratitis, accounting for 50% to 80% of cases

Ocular HSV infection can be categorised into primary and recurrent disease

Herpes simplex keratitis (HSK) is the leading cause of corneal blindness in developed countries. In UK, responsible for 1 in 10 corneal transplants

Predisposing factors

Poor general health, immunodeficiency, fatigue

Systemic or topical steroids, or other immunosuppressive drugs

Possible aggravating factors

  • sunlight (UV), fever, extreme heat or cold, infection (systemic or ocular), trauma (ocular)

History of previous attacks of ocular herpes simplex infection (key diagnostic feature)

Severe atopic disease


Usually affects one eye; may be bilateral, especially in severely atopic patients

Severity of symptoms very variable

Pain, burning, irritation, photophobia, reduced visual acuity, redness


HSK has a highly variable and unpredictable course

Can be considered as a spectrum of four distinct disease entities (with differing management strategies):


Initially punctate lesions, coalescing into dendriform pattern

  • dendritic ulcer, single or multiple
  • opaque cells arranged in a stellate pattern progressing to a linear branching ulcer, terminal bulbs may be visible
  • associated with reduced corneal sensitivity
  • continued enlargement may result in an ‘amoebic’ or ‘geographic’ ulcer (especially following inappropriate use of topical steroids)


Stromal infiltrates, vascularisation, necrosis, scarring, uveitis and keratic precipitates, possibly raised intraocular pressure

Disciform keratitis

Central or eccentric zone of epithelial oedema overlying an area of stromal thickening

Folds in Descemet’s membrane, uveitis and keratic precipitates

Metaherpetic ulcer (trophic keratitis)

Due to a combination of denervation, drug toxicity, persistent defects in epithelial basement membrane

Differential diagnosis

Herpes zoster keratitis

Bacterial, fungal or amoebic keratitis (NB Dendritic keratitis in a contact lens wearer should raise the index of suspicion of an Acanthamoeba infection)

Healing corneal epithelial defect (e. g. abrasion): may have stellate or dendritic profile

Management by optometrist

Practitioners should recognise their limitations and where necessary seek further advice or refer the patient elsewhere

Non pharmacological

Exclude viral retinitis following pupil dilatation (especially in immunocompromised patients) as this would warrant emergency (same day) referral

  • peripheral infiltrates
  • vasculitis
  • intra-retinal haemorrhages
  • vitreous inflammation

Acute Herpes Simplex: in non-contact lens wearing adults and where HSK is confined to the epithelium with classic dendritic appearance, commence antiviral therapy with ganciclovir 0.15% ophthalmic gel (NB BAK preserved preparation only) (The previously available first choice therapy for HSK, aciclovir 3% eye ointment, was discontinued by GlaxoSmithKline UK Ltd in late 2018)

NB: HSK is a potentially blinding disease and optometrists should consistently apply a low threshold for referral for this condition
(GRADE*: Level of evidence=moderate, Strength of recommendation=strong)

Recurrent Herpes Simplex: where there is:

  • a clear history of previous attacks
  • no doubt about the diagnosis and
  • only epithelial involvement
    • commence antiviral therapy (as above)

(GRADE*: Level of evidence=moderate, Strength of recommendation=strong)


Management category

B2 (modified) (acute or recurrent epithelial HSK with no stromal involvement): alleviation or palliation; monitor closely within first 72 hours to evaluate healing, but refer urgently (within one week) to ophthalmologist if epithelium has not healed after seven days
A1 (if stroma involved, or in children or contact lens wearers, or in bilateral cases): emergency (same day) referral to ophthalmologist

Possible management by ophthalmologist

Isolation and characterisation of virus from corneal swab or biopsy

PCR identification of HSV DNA or viral culture

Antivirals (topical) and/or systemic antivirals such as acyclovir or famciclovir)

Topical steroid

Epithelial débridement

Penetrating keratoplasty in some quiescent cases with scarring

Evidence base

*GRADE: Grading of Recommendations Assessment, Development and Evaluation (see http://gradeworkinggroup. org/toolbox/index.htm)

Sources of evidence

Rowe AM, St Leger AJ, Jeon S, Dhaliwal DK, Knickelbein JE, Hendricks RL. Herpes keratitis. Prog Retin Eye Res. 2013;32:88-101

Roozbahani M, Hammersmith KM. Management of herpes simplex virus epithelial keratitis. Curr Opin Ophthalmol. 2018;29:360-4

Sibley D, Larkin DFP. Eye (Lond). Update on Herpes simplex keratitis management. 2020;34(12):2219-2226

Tsatsos M, MacGregor C, Athanasiadis I, Moschos MM, Hossain P, Anderson D. Herpes simplex virus keratitis: an update of the pathogenesis and current treatment with oral and topical antiviral agents. Clin Exp Ophthalmol. 2016;44(9):824-837

White ML, Chodosh J. Herpes Simplex Virus Keratitis: A Treatment Guideline 2014. 

Wilhelmus KR. Antiviral treatment and other therapeutic interventions for herpes simplex virus epithelial keratitis. Cochrane Database Syst Rev. 2015;1:CD002898

Plain language summary

Up to 90% of people in the UK have an inactive nerve infection caused by herpes simplex virus type 1. This infection is usually acquired in childhood by contact with an adult. The viruses penetrate the skin and travel along the nerves of sensation to the central part of the nervous system (brain or spinal cord) where they become ‘latent’ and produce no symptoms. The infection cannot be eliminated and there is no protective vaccine. Another variety, herpes simplex type 2, is usually sexually transmitted, but can also affect the eye.

The infection remains inactive until some factor such as poor health, disturbance of the body’s immune system or certain drugs allow the virus to become active and then travel back down the nerves to the surface of the body. If this happens in the trigeminal nerve (the nerve that gives sensation to the head and neck), an infection of the skin such as a cold sore on the lip, or an infection of the eye surface, can occur. If the cornea (the clear window at the front of the eye) is involved, the condition is known as Herpes Simplex Keratitis. Usually only one eye is affected.

Several different forms of corneal infection are possible, ranging from slight to severe. One of them, affecting the surface skin of the cornea, produces ulcers with a characteristic branching outline and this is known as a dendritic ulcer. The infection can recur and if this happens scarring may result, which can cause blurring of vision.

A new case, with involvement of the surface skin of the cornea only, will usually be treated by the optometrist with anti-viral eye ointment. In children, contact lens wearers and where the condition affects both eyes, same-day referral to the ophthalmologist is recommended. This is a condition which tends to recur from time to time. Recurrences involving only the surface skin of the cornea can often be managed by the optometrist, who will usually prescribe anti-viral eye ointment, but if this is not effective after a week, urgent referral to the ophthalmologist is recommended. If the vision has become badly affected by scarring of the cornea, a patient may be offered a corneal transplant.

Herpes Simplex Keratitis (HSK)

Version 14

Date of search 23.01.21

Date of revision 31.03.21

Date of publication 23.07.21

Date for review 22.01.23

© College of Optometrists

View more Clinical Management Guidelines

Herpes Pictures & Symptoms of Herpes Simplex

Herpes represents a range of infections caused by different types of the herpes virus. Cold sores around the mouth can be a symptom of Herpes Simplex Virus Type 1 (HSV-1). Genital herpes, with symptoms including lesions on or around the genitals and rectum and even thighs and buttocks, is caused by Herpes Simplex Virus Type 2 (HSV-2) and is sexually transmitted.

Pictures of herpes reveal a range of symptoms. More information on the types of herpes is below.

Warning: The clinical herpes pictures on this page may be disturbing to some people. The photos are publically available in an online resource center provided by the U. S. Centers for Disease Control and Prevention. These pictures are among the least graphic and are published here in the interest of providing information to those who may wonder if they or a loved one has contracted herpes. However, none of these images nor the information on this page should be construed as medical advice nor an attempt to make diagnoses. Anyone who thinks they may be infected with the herpes virus should seek medical attention.

A cold sore on this patient’s lip was caused by the herpes simplex virus type 1 (HSV-1). (Image credit: cdc.gov)

Herpes Simplex Virus Type 1(HSV-1), which causes cold sores, is transmitted by direct contact with body fluids, such as saliva (through kissing). It can be transmitted by oral sex, too. Sharing towels or razors with an infected individual can also result spread the virus. Doctors refer to the cold sores as recurrent herpes labialis; they are also known as fever blisters. Nearly one-third of U.S. children ages 6 to 13 have tested positive for HSV-1 antibodies. More than 25 percent of children were infected by age 7 and most adults are infected. However, recurring cold sores appear in just 14 to 40 percent of those infected. There is no cure, but antiviral medication can reduce the frequency and severity of outbreaks.

Herpes Simplex Virus Type 2 (HSV-2) caused this lesion at the base of a man’s penis. Medically, the lesion is called primary vesiculopapular herpes genitalis. (Image credit: CDC)

Herpes Simplex Virus Type 2(HSV-2), or genital herpes, is transmitted by sexual intercourse or direct contact with a herpes sore. It can lay dormant for long periods in an infected person. People infected but who do not show symptoms can still spread the disease.  About 16.2 percent of U.S. residents between ages 14 and 49 are infected with genital herpes, according to the CDC. Condoms and abstinence are among the prevention strategy. There is no cure, but antiviral drugs can cut down on the frequency and severity of outbreaks.

Herpes outbreaks can cause lesions and sores in other areas of the body:

A periocular herpes outbreak occurred around the eye of a 7-year-old child with a history of recurrent herpes labialis. (Image credit: CDC)

This patient has a characteristic vesiculopapular herpes simplex lesions on his anterior thigh. (Image credit: CDC)

There are other forms of the herpes virus:

·      Herpes zoster causes shingles.

·      Scientists speculate that chronic fatigue might be caused by herpes virus 6 (HHV-6).

·      Some studies suggest HSV-1, the herpes that causes cold sores, might play a role in the development of Alzheimer’s disease.

Herpes is not just a human condition. Animals get herpes, too. And the herpes virus kills coral reefs.

A micrograph picture of the herpes simplex virus, within tissue taken from a penile lesion of a patient with genital herpes. (Image credit: CDC)

Additional pictures of herpes are available from the CDC’s image library.

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Moran CORE | Slit Lamp Photo: Herpes Zoster Ophthalmicus

Slit Lamp Photo: Herpes Zoster Ophthalmicus

Home / External Disease and Cornea / Infections Diseases of the External Eye: Basic Concepts and Viral Infections

Title: Slit Lamp Photo: Herpes Zoster Ophthalmicus
Author (s): Michael Murri, 4th Year Medical Student, Baylor College of Medicine
Date: 06/22/2016

Keywords/Main Subjects: Herpes Zoster Ophthalmicus; Pseudodendrite; Varicella Zoster
Diagnosis: Herpes Zoster Ophthalmicus
Description of Image:

Varicella zoster virus (VZV) is a double-stranded DNA virus of the herpes family that initially causes a characteristic skin rash and flu-like symptoms known as varicella or “chickenpox. ” After initial resolution, varicella zoster may lie dormant in nerve cells for decades. Herpes Zoster, also known as shingles, is caused by the reactivation of VZV, which results in painful blistering lesions and nerve pain in a characteristic dermatomal distribution. Herpes Zoster Ophthalmicus (HZO) is a reactivation of latent VZV in the ophthalmic (V1) distribution of the trigeminal nerve, which has serious implications when involving the orbit.1

A patient with HZO may present with malaise and neuralgia several days before eruption of painful vesicles, with involvement of the tip of the nose (Hutchinson’s sign) indicating involvement of the nasociliary nerve and increased risk of ocular involvement.2 Corneal involvement may include epithelial erosions, cell and flare in the anterior chamber and the appearance of pseudodendrites on the corneal surface. As opposed to dendrites associated with HSV, pseudodendrites do not have terminal end bulbs, have weaker fluorescein staining, and present more of an elevation with a “stuck on” appearance as opposed to an ulceration in HSV. Distinguishing HSV from VZV by physical findings can be important as the dosage of antiviral treatment must be elevated for VZV.  Maximal treatment benefit is seen when the correct dose is initiated within 72 hours of presentation.3 Definitive diagnosis can be achieved through viral culture. Treatment often consists of oral and topical antivirals as well as pain management. There is a lack of evidence that corticosteroids aid in outcomes.4 In some patients, prophylactic treatment must be continued indefinitely in order to prevent recurrence.

This image is a fluorescein stained corneal of a 71 year old white male with a history of recurrent HZO. On exam, he was found to have resolving skin lesions in the ophthalmic V1 distribution as well as this corneal epithelial elevation, which on staining was identified as a pseudodendrite without terminal end bulbs. Because of the patient’s history of recurrent HZO, he was treated with 800 mg of oral acyclovir five times daily and ganciclovir ophthalmic gel four times a day.


  1. Cohen EJ. Management and Prevention of Herpes Zoster Ocular Disease. Cornea. 2015; 34. doi:10.1097/ico.0000000000000503.
  2. Anderson E, Fantus RJ, Haddadin RI. Diagnosis and management of herpes zoster ophthalmicus. Disease-a-Month. 2017; 63(2):38-44. doi:10.1016/j.disamonth.2016.09.004.
  3. Mcdonald EM, Kock JD, Ram FS. Antivirals for management of herpes zoster including ophthalmicus: a systematic review of high-quality randomized controlled trials. Antiviral Therapy. 2011; 17(2):255-264. doi:10.3851/imp2011.
  4. He L, Zhang D, Zhou M, Zhu C. Corticosteroids for preventing postherpetic neuralgia. Cochrane Database of Systematic Reviews. 2008. doi:10.1002/14651858.cd005582.pub2.

Faculty Approval by: Amy Lin, MD; Griffin Jardine, MD
Identifier: Moran_CORE_24172
Copyright statement: Copyright 2017. Please see terms of use page for more information.

90,000 ER HERPES in the eye: causes, duration and treatment

Anyone, even a newborn, is at risk of suffering herpes in the eye or eyelid a disease caused mainly by the herpes simplex virus (HSV), which is present and dormant in most of the world’s population.

Ophthalmic herpes causes tearing, pain, photophobia, blurred vision and small wounds that can be very annoying. Treatment of this condition over time is important to avoid serious complications such as uveitis.

En Área Oftalmológica Avanzada we detail everything you need to know about this condition.

Herpes on the eyelids lasts between 5-10 days.

Why does herpes come out of the eye and how long does it last?

Herpetic eye disease is a condition that can be caused by various types of viruses that affect both the eye and the eyelid. Most common viruses:

  • El is a simple virus or type 1 , which is also responsible for herpes. This virus is found in the human body and it is only when it wakes up that it can cause conditions such as cold sores or cold sores. This type of herpes can cause inflammation of the cornea known as keratitis and get to cause corneal ulcers.
  • Another virus that can cause herpes in the eyelids and eyes is zoster virus or type 2 .This virus is responsible for chickenpox and shingles, and when it affects any eye, we are talking about osteochondrosis of the eye.

Both viruses are present in the human body and can spend a lifetime in sleep.However, when the immune system is weakened by any disease, the risk of any of these viruses wakes up and causes cold sores in a specific part of the body.

Herpes on the eyelids is annoying, unsightly and can be hazardous to eye health. Many people wonder how long they will last until they are completely cured, but it is difficult to find the right answer. Every person reacts differently to herpes in the eyes. Ophthalmic herpes it usually disappears a few days after starting treatment However, as with herpes, as soon as it appears, it becomes cyclical, that is, it can recur so often.

Is herpes in the eye contagious?

It is true that herpes on the eyelids or eyes is contagious if you have direct contact with one of these lesions and one of the viruses that cause this condition wakes up in the body. That is, if you have already suffered previous episodes and touched someone else’s herpes, it is very likely that the defeat has been transferred. Even touching the lip lesion and then laying hands on the eyes can cause cold sores in the eyes of people with an active virus.

If you have never suffered from herpes or eyes, the risk of infection is much lower.

Symptoms of eye herpes

The signs and symptoms of eyelid herpes can vary depending on the virus that caused it.

Symptoms of ocular herpes due to herpes virus:

  • Pain in or around the affected eye
  • Redness and rash
  • Irritation of the eyelids and around the eyes.
  • Irritation that can also appear on the forehead or tip of the nose.
  • Corneal edema.

Herpes simplex symptoms caused by herpes simplex virus:

  • Decreased vision
  • Pain in or around the eyes
  • Ocular redness
  • Feeling of sand or a foreign body inside the eye.
  • Pain and sensitivity to light.
  • Corneal edema

Treatment of herpes in the eyes

As mentioned earlier, ocular herpes is a cyclical condition that, once it appears, can recur several times throughout life.Unfortunately, there is no definitive treatment that fights the viruses responsible for this injury in the body. Therefore, depending on the type of virus causing ocular herpes simplex disease, specific treatment is necessary to treat the lesion and prevent future relapse.

Treatment of ophthalmic herpes zoster

If you are wondering how to cure herpes on the eyelids, you have to think about what type it is. If this is the Zoster virus, then the consumption of antiviral drugs is the key to treating this and any other disease.Antibiotics are not considered an effective option. Because it is an ocular lesion, the specialist will also prescribe eye drops to soothe symptoms and prevent serious complications. If the herpes infection has spread to the cornea, treatment may include corticosteroid drops. Shingles is also treated with antihistamines, anti-inflammatories, and analgesics.

Treatment of ocular herpes

This type of herpes in the eye is also treated with antiviral drugs in the form of drops or ointments.However, due to the excessive tearing caused by this condition, constant eye cleaning is an integral part of effective treatment. In addition, it is likely that the healthcare professional is prescribing anti-inflammatory drugs to reduce the swelling of the cornea and eyelids.

In case of a herpes lesion in the eye, you should immediately contact an ophthalmologist, as treatment may vary depending on the conditions of each person’s eyes.


Article title

Herpes in the eye or eyelid


Herpes in the eye is a common disease that occurs cyclically, that is, if we already have it, it can appear again.


Área Oftalmológica Avanzada

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Área Oftalmológica Avanzada

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90,000 Treatment of herpes in the eyelid

Herpes in the eyelid occurs in 2-3% of the total number of cases of herpesvirus infection. But it is precisely this location of the rash that damages the area of ​​the skin around the eyes that can create conditions for the development of severe complications.

Symptoms and Manifestations

Herpes on the eyelid consists of several yellowish vesicles located from the corner of the eye to the central part of the eyelid. Most often, the first elements of the rash appear in the area of ​​the inner corner of the eye. Without the necessary special treatment, the bubbles instantly spread to the inner part of the eyelid, in which case viral conjunctivitis can develop.

The causative agent is the Herpes virus of the first (simple) type.Symptoms of defeat: fever, headache, general weakness. Further, the skin of the eyelids and face turns red, the exudate filling the vesicles becomes cloudy, and the rashes themselves spread to both eyelids.

Treatment of herpesvirus infection on the eyelids

Treatment of herpetic eruptions on the eyelids should be started from the moment the very first bubbles appear and a medical opinion is established. If vesicles appear on the eyelids, you do not need to rush to the pharmacy for antiviral drugs right there! First of all, you need to contact an optometrist.Treatment options vary.

For single rashes, ointments are used for local treatment. To heal herpes sores on the eyelid, the agent treats the damaged areas 5-6 times during the day. Treatment time is 7 days. In the presence of multiple rashes, a systemic intake of drugs is required: “Acyclovir”, “Valacyclovir”, “Famciclovir”.

In addition, depending on the activity of the manifestation of the disease, treatment can be carried out with a number of other antiviral drugs.Today, pharmacies offer a wide range of antiviral drugs, inexpensive but effective . But, the doctor should prescribe them.

To activate and support the body’s own defenses, drugs containing interferon are prescribed. These include rectal suppositories “Viferon”, “Kipferon”. An aqueous solution of Poludan is used as a local immunomodulator. The drug is instilled into the conjunctival sac. The procedure is carried out several times a day.This is done to prevent the spread of infection, as well as to strengthen the immune system.

Symptomatic treatment is also possible. This treatment allows the patient to get rid of pain, burning, and fever. Agree, the sensations are not pleasant. Non-steroidal anti-inflammatory drugs (based on ibuprofen) are used.

But the best way not to get sick is prevention. In this case, it is strengthening the immune system, excluding close contacts with sick people. And you should also know that herpes are transmitted by contact.Try not to touch your face with your hands when in a public place. You may have just touched an object that was touched by a person with an infection.

Treatment of eye herpes

Herpes of the eye is a common recurrent viral disease that affects the eyes. The causative agent is the herpes simplex virus type 1. Herpes simplex virus type 1 causes retinal inflammation and scarring. This condition is sometimes referred to as eye herpes.Eye herpes is spread by close contact with an infected person.

Types of herpes eyes

In some cases, herpes is not dangerous, in others it threatens blindness. There are the following types of herpes of the eyes:

  • Herpetic keratitis is the most common type of eye herpes that affects the cornea. Herpetic keratitis affects only the upper layer (epithelium) of the cornea. Leaves no scars.
  • Stromal keratitis. The infection affects the deep layers of the cornea. Stromal keratitis causes corneal scarring, vision loss, and blindness. It is believed that the cause of the disease is the late response of the immune system to the initial infection.
  • Iridocyclitis is a severe form of herpes of the eyes, which causes inflammation of the iris and surrounding tissues inside the eye. The characteristic manifestations of the disease are increased photosensitivity, “fog” in front of the eyes, pain and redness of the eyes.Iridocyclitis is a type of uveitis that usually affects the anterior region inside the eye.
  • Infection of the retina or the inner lining of the posterior chamber of the eye is called retinal herpes.

Symptoms of herpes of the eye

Ophthalmic herpes is accompanied by a number of symptoms. In some cases, the cornea becomes inflamed, resulting in irritation and occasional sharp pain in the eyes. In addition, the cornea becomes cloudy, and there is a feeling of “fog” before the eyes.

Eye herpes symptoms:

  • Herpes of the eye can cause inflammation and scarring of the surface of the eyes (cornea)
  • Edema of the eye area
  • Lacrimation
  • Recurrent eye diseases
  • Irritation
  • Sensation of a foreign body in the eyes
  • Eye redness
  • Herpetic fever in the eyes
  • Watery discharge from eyes
  • Light sensitivity

The variety of symptoms often makes it difficult to diagnose herpes of the eye.

Causes of herpes of the eye

Herpes of the eye is transmitted by contact with an infected person and by self-contact. For example, with herpes on shirts, you can infect your eyes.

Patients with significant corneal involvement may require a corneal graft.

The herpes simplex virus enters the body through the nose or mouth. It penetrates into clusters of nerve cells and is inactive there. The virus may not remind of itself in any way for many years and may not even “wake up” at all.The exact reasons for the sudden activation of the virus are unknown. It is believed that the virus “wakes up” when our body is under stress, for example, at high temperatures, sunburn, dental and surgical interventions, injuries.

Eye herpes treatment

The choice of treatment is determined by the location of the herpes virus. Herpes can affect the corneal epithelium, corneal stroma, iris, retina, etc. In some cases, treatment causes deterioration, therefore there are no general recommendations, and treatment is prescribed individually.

If the infection only affects the surface of the eye, give antiviral eye drops, ointments, or oral antiviral drugs.

The doctor can treat the affected area by removing dead epithelial cells from the cornea using a cotton swab or a special tool – a corneal spatula. After the procedure, your doctor will prescribe you to wear a bandage or soft lenses to speed up the healing of the cornea.

Steroid eye drops successfully fight inflammation in the deep layers of the cornea and prevent scarring.Typically, steroid drops are used at the same time as antiviral drops.

Steroid drops reduce the local immunity of the eyes. In this regard, patients who have previously suffered from herpes of the eyes should use only steroid drops prescribed by the attending physician.

It is known that steroid drops are the cause of recurrence of herpes of the eyes in patients predisposed to the herpes virus. Antibiotic eye drops and medicated contact lenses can help prevent secondary bacterial infections while treating herpes simplex.

Surgical treatment is prescribed in case of corneal scars that cannot be removed with steroid drugs. In case of irreversible scarring of the cornea, a corneal graft will help restore vision.

Although herpes is an incurable disease, treatment will help control the frequency of its occurrence. Research is currently underway to find the most effective methods for controlling the disease.

If you have any vision problems, please contact the specialists of the Medizehelp ophthalmological center.Experienced specialists will advise you and, if necessary, prescribe the most effective treatment.

Entrust your vision to professionals!

90,000 Herpetic infections in children

Herpesvirus infections – a group of infectious diseases that are caused by viruses from the Herpesviridae family, can occur in the form of localized, generalized, recurrent forms of the disease, have the ability to persist (constant presence of the virus) in the human body.

Herpesvirus infections (HVI) are among the most common viral diseases in humans. Infection and incidence of them increases every year. In all countries of the world, 60-90% of the population is infected with one or another herpesvirus.


Herpesviruses contain double-stranded DNA and have a glyco-lipoprotein envelope. The sizes of viral particles are from 120 to 220 nm.

Today, 8 types of herpes viruses have been described that have been identified in humans:

  • two types of herpes simplex virus (HSV-1, HSV-2),
  • varicella zoster virus (VZV or HHV-3),
  • Epstein-Barr virus (EBV or HHV-4),
  • cytomegalovirus (CMV or HHV-5), HHV-6, HHV-7, HHV-8.

Based on the biological properties of viruses, 3 subfamilies of herpes viruses have been formed: (alpha-herpes viruses, beta-herpes viruses and gamma-herpes viruses). A-herpes viruses include HSV-1, HSV-2, VZV.

Beta herpes viruses include CMV, HHV-6, HHV-7. They, as a rule, multiply slowly in cells, cause an increase in the affected cells (cytomegaly), are capable of persistence, mainly in the salivary glands and kidneys, and can cause congenital infections. Gamma herpes viruses include EBV and HHV-8.

Herpes simplex virus types 1 and 2

The term herpes infection (HS) is commonly used in reference to diseases caused by HSV-1 and HSV-2. The source of HSV infection is sick people with various forms of the disease, including latent, as well as virus carriers.

HSV-1 is transmitted by airborne droplets and by contact. A virus that gets on the skin during a cough or sneeze, which is in droplets of saliva, survives for an hour. On damp surfaces (washbasin, bath, etc.), it remains viable for 3-4 hours, which is often the cause of disease outbreaks in kindergartens.Infection can be carried out by kissing, as well as through household items that are infected with the saliva of a patient or a virus carrier. HSV-2 is transmitted sexually or vertically. With the latter, infection occurs during childbirth (contact with the birth canal of the mother), transplacentally or through the cervical canal in the uterine cavity. Due to the fact that during the generalization of infection, viremia occurs, a transfusion or parenteral route of transmission of HSV-2 infection is also possible. HSV-2 usually causes genital and neonatal herpes.

The greatest susceptibility to GI in children aged 5 months to 3 years. Depending on the mechanism of infection, the acquired and congenital forms of GI are distinguished. Acquired GI can be primary and secondary (recurrent), localized and generalized. The latent form of GI is also distinguished.

No other infection has such a variety of clinical manifestations as herpesvirus. It can cause damage to the eyes, nervous system, internal organs, mucous membrane of the gastrointestinal tract, oral cavity, genitals, can cause cancer, has a certain value in neonatal pathology and the occurrence of hypertension.The spread of the virus in the body occurs in a hematogenous, lymphogenous, neurogenic way.

The incidence of primary herpesvirus infection increases in children after 6 months of age, when the antibodies received from the mother disappear. The peak incidence occurs at the age of 2-3 years. Often, GI also occurs in newborns; according to a number of authors, it is diagnosed in 8% of newborns with general somatic pathology and in 11% of premature babies.

According to the WHO, diseases caused by the herpes simplex virus (HSV) are the second leading cause of death from viral infections after influenza.Solving the problem of diagnosing and treating herpesvirus infection with manifestations on the oral mucosa is one of the most important tasks of practical medicine.

Over the past decade, the importance of herpesvirus diseases as a public health problem has been steadily increasing throughout the world. Representatives of the human herpesvirus family affect up to 95% of the world’s population.

The primary forms of GI include: infection of newborns (generalized herpes, encephalitis, herpes of the skin and mucous membranes), encephalitis, gingivostomatitis, Kaposi’s herpetiformis, primary herpes of the skin, eyes, herpes felon, keratitis.Primary GI occurs as a result of a person’s initial contact with HSV. As a rule, this occurs in early childhood (up to 5 years). In adults aged 16-25 who do not have antiviral immunity, primary GI is more likely to be due to HSV-2. 80-90% of initially infected children latently carry the disease, and clinical manifestations of the disease are observed only in 10-20% of cases.

Secondary, recurrent forms of GI are herpes of the skin and mucous membranes, ophthalmic herpes, genital herpes.

Epstein-Barr virus infection

An infectious disease caused by the Epstein-Barr virus (EBV) and is characterized by a systemic lymphoproliferative process with a benign or malignant course.

EBV is excreted from the body of a patient or virus carrier with oropharyngeal secretions. The transmission of infection occurs through airborne droplets through saliva, often during the kissing of the mother of her child, which is why sometimes EBV infection is called “kissing disease”.Children often become infected with EBV through toys contaminated with the saliva of a sick child or a virus carrier, when using common utensils, linen. Possible blood transfusion transmission of infection, as well as sexual. Cases of vertical transmission of EBV from mother to fetus have been described, suggesting that the virus may be the cause of intrauterine developmental abnormalities. The contagiousness in EBV infection is moderate, which is probably due to the low concentration of the virus in saliva. The activation of infection is influenced by factors that reduce general and local immunity.The causative agent of EBV infection has a tropism for the lymphoid-reticular system. The virus enters the B-lymphoid tissues of the oropharynx, and then spreads throughout the entire lymphatic system of the body. Infection of circulating B-lymphocytes occurs. The DNA of the virus enters the cell nuclei, while the proteins of the virus give the infected B-lymphocytes the ability to multiply continuously, causing the so-called “immortality” of B-lymphocytes. This process is a characteristic feature of all forms of EBV infection.

EBV can cause: infectious mononucleosis, Burkitt’s lymphoma, nasopharyngeal carcinoma, chronic active EBV infection, leiomyosarcoma, lymphoid interstitial pneumonia, hairy leukoplakia, non-Hodgkin’s lymphoma, congenital EBV infection.

Varicella-zoster infection

Varicella-zoster virus causes chickenpox and herpes zoster. The source of chickenpox infection can only be a person with chickenpox or herpes zoster, including the last 24-48 hours of the incubation period. Chickenpox reconvalescents remain infectious for 3-5 days after the skin rash stops. The disease is not transmitted through a third party. In utero infection with chickenpox is possible in case of illness of a pregnant woman.Chickenpox can occur at any age, but in modern conditions, the maximum number of patients falls on children aged 2 to 7 years. Herpes zoster develops after a primary infection with the Varicella-zoster virus, after the transition of the infection to a latent form, in which the virus is localized in the spinal, trigeminal, sacral and other nerve ganglia. Endogenous reactivation of the infection is possible.

Cytomegalovirus infection

An infectious disease caused by cytomegalovirus (CMV) and is characterized by various clinical forms (from asymptomatic to severe generalized with damage to many organs) and course (acute or chronic). Transmission factors for CMV can be almost all biological substrates and human secretions that contain the virus: blood, saliva, urine, cerebrospinal fluid, vaginal secretions, semen, amniotic fluid, breast milk. A potential source of infection is organs and tissues in transplantation, as well as blood and its products in transfusiology. Ways of transmission of CMV infection: airborne, sexual, vertical and parenteral.

Distinguish between congenital and acquired forms of CMV infection.Congenital CMV infection. With antenatal infection of the fetus, infection occurs mainly transplacentally. With intrapartum infection, CMV enters the body through the aspiration of infected amniotic fluid or secretions from the mother’s birth canal.

In older children, acquired CMV infection occurs in 99% of cases in a subclinical form. The most common manifestation of this form of CMV infection in children over the age of one year is mononucleosis-like syndrome.As a rule, there is a clinic of acute respiratory disease in the form of pharyngitis, laryngitis, bronchitis.

Infections caused by the sixth, seventh and eighth types of herpesviruses Herpesviruses of the sixth type (HHV-6) can cause erythematous and roseolous rashes (sudden exanthema), lesions of the central nervous system and bone marrow in immunocompromised children. Herpesviruses of the seventh type (HHV-7) cause exanthema of newborns

Cytological, immunofluorescent, serological and PCR methods are valuable for the diagnosis of herpes infection.
Virological examination for herpes infection reveals complement-binding antibodies to HSV-1 or -2 in the mother’s blood, fetal cord blood and amniotic fluid.
PCR method. The material for research on herpes is blood, swabs from the pharynx, the contents of the vesicles, ulcers, urine.

It is important to study specific antibodies of various subclasses: IgM, IgG1-2, IgG3 and IgG4 to herpes viruses. The detection of specific immunoglobulins M, IgG3, IgG1-2 in the blood serum of children in a titer> 1:20, viral antigen and specific immune complexes with the antigen indicates the severity of the infectious process (active phase), and the determination of only specific IgG4 is regarded as a latent phase of infection or carriage of maternal antibodies.


Herpetic infection takes place in 3 stages:

  • Stage 1 – in the active stage or with exacerbation of the chronic course of the disease;
  • Stage 2 – prolonged treatment with maintenance doses during remission;
  • Stage 3 – identification and rehabilitation of chronic foci of infection, examination of family members to identify the source of infection.

In all cases, the drugs, their combination and duration are selected individually, taking into account the manifestations of the disease, the characteristics of the child’s immune system, age, course of the disease.

90,000 Herpetic keratitis: causes, symptoms, treatment

Table of Contents

Herpesvirus diseases account for more than 50% of corneal inflammations. The cornea is the most convex part of the eye membrane, which refracts light to act as a lens. Herpetic eye disease or ophthalmic herpes is one of the manifestations of herpes infection. The virus can infect the cornea, causing herpetic keratitis.

Almost 90% of the population are considered carriers of the herpes virus. According to statistics, 200 thousand people fall ill with ophthalmic herpes in Russia a year. The disease affects both adults and children. Let’s figure out what it is – herpes of the eyes, how and how to treat the infection and its consequences.


The causative agents of the infection are herpes viruses type 1 and 2, chickenpox virus or shingles. They all belong to the herpesvirus family. You can get infected with the herpes simplex virus type 1 by airborne droplets, by contact with a patient, by kissing.Infection is observed even in childhood. The second type enters the body through the genital tract or is passed on during labor from mother to child.

After introduction into the body or after the first episode of herpes infection, the virus remains either on the cornea or in the trigeminal nerve in an inactive state.

Reactivation of the virus occurs if the following risk factors are present:

  • Acute respiratory viral infections.
  • Hypothermia or overheating.
  • Exposure to ultraviolet rays.
  • Decrease in body resistance.
  • Laser exposure to the eyes.
  • Use of certain eye drops for the treatment of glaucoma.
  • Taking antibiotics, corticosteroids and antiviral agents.
  • Microtrauma of the cornea, especially when wearing lenses.
  • Nervous tension or chronic stress.
  • Hormonal imbalance or pregnancy.
  • Alcohol abuse.

After the first case of inflammation, herpes keratitis develops again within a year in 25% of cases. If a person has had ophthalmic herpes twice already, the probability of recurrence within a year increases to 50%, if more than two – up to 75%.

Specificity of the disease

Herpes simplex virus type 1 infects the skin, especially along the nerves, and mucous membranes. The severity of ophthalmic herpes depends on the properties of the virus and the immune response. Herpes affects the eye membranes after it overcomes their protective barrier, consisting of substances in the composition of the tear fluid: the natural antiviral substance interferon and protective immune particles – secretory mucus immunoglobulins (IgA).

Herpesvirus enters the eye tissue from the external environment, through nerve fibers or through the bloodstream. On the cornea, it actively multiplies, causing cell damage and triggering an inflammatory response. Corneal cells undergo degeneration, are destroyed and slough off. If only the surface layer of cells is affected, the tissue defect is repaired, and the virus goes into hibernation.

If the connective tissue of the cornea is involved in the process, which is observed in deep keratitis, there is direct damage to the cells by the virus itself and additional damage by immune cells.The virus is able to mimic the structure of corneal cells, so the immune system attacks not only viral particles, but also corneal cells.

Herpes simplex virus type 2 infection develops in 1 in 500 babies under 6 months of age because the mother passes antibodies to the virus to the baby during pregnancy.

Symptoms of the disease

For keratitis, the so-called corneal syndrome is typical, that is, signs of irritation of the cornea.Symptoms of herpetic keratitis at the onset of the disease are difficult to distinguish from signs of bacterial inflammation. The patient has:

  • Lachrymation.
  • Photophobia.
  • Spasm of the century.
  • Redness of the eye membranes.
  • Sensation of a foreign body in the eye.
  • Discomfort, pain or pain.

At this stage, healing can occur without changing the structure of the tissues. If the disease progresses or recurs frequently, the virus penetrates deeper layers.The skin around the eyes and eyelids are covered with blistering eruptions. As a rule, one eye is affected. Vesicles quickly open, and ulcerations form in their place.

Herpes keratitis is often combined with acute conjunctivitis – inflammation of the outer membrane of the eye. With this course, the parotid lymph nodes may increase.

Forms of herpetic keratitis

Inflammation of the cornea caused by the herpes virus is primary and secondary or post-primary.Primary ophthalmic herpes occurs when the body does not yet have antiviral antibodies. As a rule, the first infection develops in children under 5 years of age, less often the primary form occurs between the ages of 16 and 25.

A feature of primary ophthalmic herpes is a severe course, a tendency to general intoxication of the body and concomitant damage to the skin or oral cavity. Post-primary herpetic keratitis is sluggish.

Distinguish between superficial and deep forms of repeated inflammation of the cornea caused by herpes.Superficial includes vesicular and dendritic keratitis. Deep or stromal – metaherpetic and disc-shaped.


With vesicular keratitis, grayish vesicles are formed. Due to the appearance of ulcers at the site of the opened vesicles, the epithelium exfoliates. At the same time, tissue nutrition sharply deteriorates, the regeneration process proceeds slowly, as a result of which the sensitivity of the cornea decreases, it becomes cloudy. The lesion is usually unilateral, but the infection often recurs.

Treelike keratitis

In this form, severe pain develops in the initial stage. The patient is worried about the expressed photophobia, sometimes “flies” appear before the eyes. Bubbles gradually form on the cornea. In place of the merged bubbles, gray furrows are formed. Because of them, lightning and spots appear in the field of view.

Inflammation provokes detachment of the surface layer, forming ulceration. Anneal inflammation proceeds for a long time and in a sluggish form, complicated by inflammation of other ocular membranes, impairing vision and causing significant corneal opacity.

Metaherpetic keratitis

Usually develops after a tree-like lesion, especially if the disease is not treated on time or the wrong doses of hormonal drugs are prescribed. With this deep version of ophthalmic herpes, the area ulcerated with treelike inflammation is rejected, and the zone of inflammation gradually increases and deepens.

The cornea swells, thickens, becomes cloudy gray, and then becomes covered with numerous erosions or ulcers. Gradually, white scars form at the site of erosion.

Disc type

This option is slow, the symptoms are moderate. But fluid builds up in the cornea and becomes infected. Because of this, the central part of the shell is damaged, which causes pain in the eyeball.

Gradually, the edema thickens, and in its place, gray-white foci with clear contours, consisting of scar tissue, are formed, there are no ulcers. The denser the cornea becomes, the less sensitive it is and the stronger the pain. Dense tissue refracts light worse, which leads to visual impairment.


This variant is characterized by simultaneous inflammation of the cornea and iris, on which the eye color depends. The patient has tingling sensations and sudden attacks of eye pain. The pain is associated with irritation of the trigeminal nerve, so it can spread to the forehead or temples.

A small network of blood vessels is affected, and with progression, purulent fluid can flow out of the eye. If the process continues, intraocular pressure rises.The pupil is dilated, and when viewed around it, a halo is visible.


Diagnosis of herpetic keratitis begins with an examination. The presence of characteristic vesicles suggests a lesion caused by herpes. Since the disease can proceed sluggishly, without characteristic manifestations, the diagnosis is clarified using laboratory and instrumental studies. To detect the pathogen, take a scraping from the affected tissue or tear fluid.

Laboratory diagnostics of ophthalmic herpes includes:

  • Investigation of scraping from the conjunctiva by the method of fluorescent antibodies.
  • Enzyme immunoassay.
  • Analysis of blood or tear fluid for antiherpetic antibodies.
  • Polymerase chain reaction (PCR) of biological fluids, detecting a virus.

Instrumental examination helps to assess the degree and depth of anatomical changes. Instrumental diagnostics includes anterior optical coherence tomography, biomicroscopy and fluorescein test.

A fluorescein test is performed to identify ulcers or films on the cornea, to assess the area and extent of the lesion.After applying the solution to the eye, the ophthalmologist examines the tissue using a slit lamp with a blue filter.

Treatment methods

The method of therapy depends on the severity of the disease, the form and time of visiting a doctor. In the initial stages, symptoms can be effectively eliminated, recurrences can be prevented with the help of conservative or non-surgical treatment.

In severe cases, surgical correction of the sequelae of ophthalmic herpes is performed. The main goal of therapy is to stop the spread of the corneal defect and to stimulate the healing of ulcers.

Conservative treatment

Conservative therapy includes medications and physiotherapy. Suitable for the elimination of superficial forms of the disease. For milder forms, you can be treated at home, for moderate and severe forms, treatment is carried out in the department of ophthalmology.

In case of herpetic keratitis, the eyes are treated with the following medications:

  • Antiviral drugs.
  • Wound healing agents.
  • Antioxidants.
  • Antibiotics.

Antibiotics are used if there is a risk of bacterial attachment, as indicated by purulent discharge from the eyes. Since herpes causes an autoimmune reaction, anti-allergic and anti-inflammatory therapy is carried out, especially with frequent exacerbations. The basis of immunological correction is corticosteroids or analogs of adrenal cortex hormones.

For acute infection, instillations, ointments and cleaning solutions are used topically for rinsing. At the same time, it is important to moisturize the mucous membrane in order to prevent dry eye syndrome that occurs when using hormonal, anti-inflammatory or antibacterial agents.

Gilan Ultra comfort moisturizing solution is referred to anti-dry eyes. It is identical to natural tear fluid, does not have a toxic effect on tissues. It can be instilled up to 6 times a day.

To restore the transparency of the cornea, drugs are administered using physiotherapy. For herpetic keratitis, electrophoresis with medicinal solutions is used.

Surgical treatment

The operation is performed if medications and physiotherapy do not help, and the corneal ulcer does not heal, affects the deep layers or there is a risk of rupture.In case of unexpressed changes, the doctor removes the damaged layers by scraping. But with severe structural changes, keratoplasty is performed.

Under local or general anesthesia, completely or partially replace the damaged cornea with a donor one. After the new cornea is sewn on, proper care is required. Rehabilitation lasts about a month, but the process of tissue repair can be accelerated with the help of local remedies. To prevent infection from entering the operated eye, it is necessary to keep it moist.

As a rule, after infections or operations, the release of lacrimal fluid is temporarily impaired. Dry eyes are eliminated with the help of “artificial tears”, for example, Gilan eye drops, which contain sodium hyaluronate. It is able to bind water molecules, preventing drying out of the eye membranes.


In case of herpetic keratitis, the infection is complicated by the ingrowth of blood vessels into the cornea or its opacity. In severe cases, the affected tissue exfoliates.A deep ulcer can rupture tissue, and the opacity can drastically reduce visual acuity.

In severe cases, within 1-2 days, the eye tissues can be severely deformed, and a person can lose sight. But in most cases, the process proceeds subacutely, gradually destroying the tissue. Inflammation can lead to damage to the anterior choroid and swelling of the macula, the central part of the retina.

After surgical treatment, the new cornea may not adhere. There is a risk of developing cataracts after surgery.But in almost 90% of cases, keratoplasty does not cause complications.

Preventive measures

Prevention of herpetic lesions of the eye includes strengthening the immune system and the introduction of vaccines. To avoid repeated episodes of inflammation, it is recommended to avoid hypothermia, emotional or physical stress, to take immunostimulants and vitamins during the season of acute viral infections.

When wearing contact lenses, it is important to take proper care of them: take them off at night, clean them with solutions and do not put them on the eyes after the expiration date.

The most effective method of prevention, however, remains vaccination.


The herpes virus is present in the fibers of the trigeminal nerve in 90% of the population. With a weakening of the body’s immune forces or a deficiency in the protective factors of the tear fluid, the virus causes herpetic keratitis. The disease is prone to a chronic course, frequent exacerbations and sometimes leads to serious complications, up to loss of vision.

Treatment of herpetic keratitis includes antiviral drugs, drugs that stimulate the healing of ulcers, and immunocorrection.If it is ineffective, an operation is performed – the ulcerated tissue is replaced with a new cornea taken from a donor.

Dry eye syndrome is common with both medical and surgical treatment. Until complete recovery, tear substitutes are used, for example, Gillan eye drops. The product moisturizes the cornea, relieves unpleasant irritation syndromes and prevents bacterial infection.

90,000 Purulent eye infection: description of the disease, causes, symptoms, cost of treatment in Moscow

Hundreds of eye diseases are known to ophthalmology.The most common damage to the human eye is a purulent infection. Diseases have similar symptoms and complications, but manifest and are diagnosed in different ways. Also, eye diseases differ in treatment methods.

Purulent formations, most often, are the result of colds. Pathological eye changes can become infectious agents. The appearance of pus can cause contact with dirty hands, a towel, and even bedding. Traumatic effects on the organs of vision can cause purulent lesions.

In ophthalmology, several types of purulent eye infections are distinguished: conjunctivitis, endophthalmitis, panophthalmitis, iridocyclitis. Ophthalmic herpes, fungal keratitis, corneal ulcers, dacryocystitis, blepharitis and barley. These infections cause an increased discharge of pus.

A mucous membrane that protects the eye from external influences is formed from the mucous membrane. If a person has a small amount of mucus after sleeping, this is considered normal.It consists of mucin and meibomian gland cells. This is a greasy and slimy secret, so the color of the mucus should be clear or whitish.

If the discharge is infectious, then the discharge is accompanied by redness, tearing. There is a burning sensation and itching. The amount of mucus secreted increases significantly, the color becomes yellow-green, the consistency thickens. When the first symptoms appear, you should immediately contact an ophthalmologist. It is necessary to establish the cause of the disease, its nature and an effective method of treatment.

The eye carries a very important function in human life. Thanks to vision, a signal enters our brain, and we visually form a visualization of the surrounding world. Each eye has its own function. Therefore, if even one eye is disturbed, the picture changes.

The structure of the eye consists of the following parts: cornea, eye chamber, iris, pupil, lens. As well as the optic nerve, sclera, blood vessels, retina. Each element is required for the basic functions of the eye.


The disease develops as a result of inflammation of the mucous membrane of the eye. Inflammation of the conjunctiva can be caused by an infection or allergy. There are several types of this infection: allergic, bacterial, acute and chronic. In an adult, conjunctivitis caused by adenovirus is most common. In children, adenovirus and bacterial are equally common.

The appearance of the disease can provoke various infections.All kinds of gonococci, staphylococci, streptococci, Pseudomonas aeruginosa cause bacterial damage. The development of inflammation in the eye begins with a fungal process. There are a huge number of fungal groups of irritants, for example, aspergillus, actinomycetes, spirotrihel. Medicines, contact lenses, plants, dust can cause an allergic reaction. Sometimes, conjunctivitis can be considered an occupational disease when working conditions are in a polluted environment, the eyes are exposed to external dust and gas.

The general symptoms of the disease have a number of sensations that cannot be overlooked. The eyelids begin to redden, excessive lacrimation appears, pain in the eye, edema, difficulty in visual function due to the appearance of purulent discharge.

At the first manifestations of conjunctivitis, you should seek medical help. Diagnosis of the disease is quick and easy. Visual inspection and a series of tests will determine the cause of the infection. After consulting an ophthalmologist, the most effective treatment method is prescribed.Medication includes a combination of eye drops and antibiotics. With proper and prompt treatment, complete recovery occurs within a few weeks.


A disease that occurs as a result of bacteria in the eye fluid. Infection with endophthalmitis occurs through blood circulation, trauma to the eyeball, surgical intervention. The main cause of the occurrence is postoperative complications for the elimination of cataracts, vitrectomy, glaucoma.The disease is asymptomatic, the patient seeks help when vision deterioration begins, and dark spots of various shapes appear in the eyes, which impede normal vision and eye movement.

It is very difficult to diagnose endophthalmitis in the early stages. Typical symptoms and previous surgical eye interventions become the only suspicion of the development of this pathology.

Treatment of the disease is immediate.Steroid drugs are administered enterally, antifungal agents and antibiotics are applied to the eye cavity. Approximately half of patients achieve a favorable prognosis of recovery. It depends on the cause caused by endophthalmitis, the age and health of the patients, and visual acuity. These factors affect the receipt of the result and the return of the previous visual acuity.


The infection affects the sclera and all membranes of the eye, causing acute purulent inflammation.The cause of the occurrence is the introduction of infection through the eyeball, as well as through the circulatory system. Severe pain is felt in the eye sockets. Edema, fear of light, watery eyes, blurred vision. Chills and fever are common.

The inflammation is severe and acute. The disease has severe complications. Often leads to atrophy and death of the eyeball. The infection spreads instantly through the eyelids and lacrimal glands. The multiplication of microorganisms leads to inflammation, panophthalmitis is distributed over the entire surface of the eyeball.

The causative agents of this infection are staphylococci, pneumococci, tuberculosis bacteria, Pseudomonas aeruginosa and Escherichia coli. They enter the ocular cavity exogenously or endogenously. Traumatic impact is the most common type of lesion; a purulent infection penetrates through the wound into the eyeball. Due to past diseases, such as keratitis, abscess of the eyelids, phlegmon of the orbit, endophthalmitis, panophthalmitis may develop. The causative agents of the disease can be pneumonia, typhoid, sinusitis, sepsis, tuberculosis and many other diseases.

A few days after infection, panophthalmitis affects the eyeball. The disease develops rapidly and has acute symptoms. Headache, chills, vomiting. Strong theca, cutting sharp eye pain, an abundant accumulation of pus is observed in the anterior chamber of the eye. Vision falls sharply, a person ceases to distinguish between light and darkness, complete blindness sets in. If the disease spreads and affects the internal tissues, the mobility of the apple becomes impossible. After a couple of months, pus is discharged through the openings of the sclera, the eye is squeezed out and atrophied.Pus can affect the meninges, meningitis develops, as well as an abscess.

Panophthalmitis is diagnosed by an ophthalmologist when examining and assessing the existing injuries of the eyeball. Various types of ophthalmological examinations are prescribed. Timely diagnosis and treatment is the only way to recover. Enhanced antibiotic therapy is prescribed immediately. Antifungal agents are prescribed. Apply trays, special intravenous droppers from salt solutions.

Medication can be powerless. In such cases, the removal of the cornea and the inside of the eyeball is urgently prescribed. Evisceration is used for loss of vision. An implant is sewn into the orbit and the cleaned area is sutured.

Ophthalmic replacement is performed in the absence of an eyeball. An ocular prosthesis can be made of a variety of materials. The prosthesis is first installed in a small size, for the patient to get used to its wearing. The size is gradually increasing.After wear and tear, the denture should be replaced.

Herpes eye

The disease is caused by the simple herpes virus. Patients of any gender and age are at risk. Small purulent balls appear on the eyelids, which cut the hole, irritate the mucous membrane. There is redness, tearing, fear of light. More than 90% of the population suffers from the herpes virus. Herpes in the eye occurs when the trigeminal nerve is inflamed. Symptoms progress.

Herpes is diagnosed only by laboratory tests.Eye ointments, immunomodulators are prescribed. Eye drops are used to limit damage to healthy tissues. Novocaine blockade will relieve pain and inflammation.

Fungal keratitis

The disease is caused by a virus, bacterium or fungus. The corneal tissue is affected. It is accompanied by pain and redness. The transparency of the cornea deteriorates, there is a spasmodic closure of the eyelid. There are many causes of keratitis, such as trauma, allergic reactions, influenza and SARS.Parasitic fungi infect the cornea, causing severe damage to it. The consequence can be loss of vision or an eyesore.

Endogenous iridocyclitis

Inflammation of the iris and ciliary body. Causes of occurrence: arthritis, gout, psoriasis. Various infectious diseases that are caused by bacteria. For example, flu, measles, herpes, sinusitis, sinusitis.

When the eye is damaged, pain syndrome, lacrimation, photophobia, and decreased vision appear.The blood vessels in the eye dilate. The iris of the eye changes color. Pupils do not react well to light. Bloody and purulent accumulations appear at the bottom of the chamber.

The diagnosis is established according to the patient’s complaints. The eyes are examined using a special microscope. The pupil may be constricted and not naturally shaped. Treatment is prescribed by an ophthalmologist. Antihistamines, corticosteroids, and antibiotics may be indicated.


Barley can be caused by a tick or bacterial infection.The hair follicle becomes inflamed, and the accumulation of pus begins. Weakened immunity and bacterial infection, stress, skin diseases, anemia, eye contamination, worms can cause barley.

There is redness and swelling of the affected eye. A pimple appears on the basis of the focus, from which yellow pus is released. A rise in body temperature, chills, an increase in lymph nodes accompany the course of the disease.

During a medical examination, a study is carried out for the presence of a skin mite, urine and blood tests are taken, and the sugar level is checked.Treatment of barley begins with the treatment of the abscess with tinctures or alcohol. Antibacterial drops, tetracycline ointment, vitamin therapy to raise immunity are prescribed.

It is strictly forbidden to squeeze out barley. The infection can spread to the entire eyelid. The use of the prescribed funds by an ophthalmologist will lead to complete recovery in a week.


The inflammatory process takes its origin in the lacrimal sac. There is redness and swelling in the lacrimal opening.The pain can be given to the nose and jaw. Purulent discharge comes out of the lacrimal sac.

Dacryocystitis is congenital and acquired. The diagnosis is made by visual examination and analyzes. Antibiotic therapy is selected. Lavage and probing of the lacrimal canals are used. CT or MRI is used to detect neoplasms and changes caused by dacryocystitis. To prescribe an effective treatment, you should find out the cause of the disease. You need to get rid of it at the same time.


The disease of the eyelids and their edges is called blepharitis. The eyelids change their shape due to swelling, redness is observed, patients often blink. The cause of the occurrence can be various diseases, for example, gastritis, sinusitis, colitis. Allergies, lack of vitamins, infections, are also the cause of the development of the pathological process. This disease is most often chronic. It is difficult to treat.

The bulk of diseases appear due to bacterial damage.Personal hygiene rules should be followed. Always keep your face and hands clean. The use and dosage of any drugs can only be prescribed by an ophthalmologist, based on the examination and research.

Many factors lead to loss of vision and the eyeball itself. In this case, ocular prosthetics are used. The shape of the prosthesis mimics the human eye. It does not transfer the visual function, but maintains the organs of vision in the anatomical position and improves the aesthetic appearance.This is a narrow area in ophthalmology that every clinic cannot afford.

useful information from the Medical Center No. 1

What Causes Inflammation?

The reasons that cause inflammation are mainly associated with non-observance of simple hygiene rules: using someone else’s cosmetics, not washing off cosmetics before going to bed, dirty hands that rub the eyes, getting staphylococcus into the eye. But it happens that barley on the eye is provoked by the demodex eye mite.It is located near the root of the eyelash or eyebrow. The cause of the disease can be hidden under concomitant diseases: diabetes mellitus, helminthic disease, lowered immunity, problems with the gastrointestinal tract. It is precisely the constant nature of the onset of the disease that indicates a concomitant disease. Therefore, it is her that will have to be treated. If you cannot quickly cure barley and the next one immediately forms in place of the old one, then you should consult a dermatologist, since blepharitis or conjunctivitis can cause inflammation.Wikipedia claims that among the main causes of the disease there is a period of decreased immunity during colds. But the list of reasons also includes periods after operations, stressful or depressive conditions, physical and nervous exhaustion, anemia.

The main signs of the disease

On the first day of the disease, discomfort is felt in the area of ​​the eye eyelid. Then more serious symptoms begin to appear, such as redness, itching, burning, swelling. Sometimes barley on the eye causes headaches and fever.After 2 days, a tubercle with a yellow or white ending forms on the eyelid. In order to quickly cure barley, you do not need to touch the abscess and in no case squeeze out the pus. The abscess will open approximately on the 4th day of illness, after which the discomfort in the eye should go away. Photo 2 was taken after opening the abscess. Since barley is not contagious, there is no need to isolate the patient from other family members. If there is an internal inflammation, then the pus will not come out to the surface of the eyelid, but will pour out into the conjunctival sac.True, there are cases when it is possible to cure barley of internal origin and get chronic inflammation of the meibomian gland. Chalazion will not bother with pain, but it will be noticeable visually.

How to cure inflammation?

It is impossible to cure barley in the eye with one magic remedy. But you can significantly speed up the process of pus release. To do this, on the first day of the disease, rubbing the itchy area of ​​the eyelid is prescribed. Treatment consists of the drying effect of iodine, a solution of brilliant green or medical alcohol.This procedure is repeated several times during the day. The disease at this stage will require the use of eye drops and ointments. Drops are used several times a day. For this, tobrex, chloramphenicol or cypromed are suitable. A tetracycline or hydrocortisone ointment is placed behind the eyelid during sleep. Treatment will be significantly accelerated if you undergo a UHF course, but only after consulting your doctor. In no case try to cure barley by warming the eye at home. Barley on the eye will go away faster if you follow a cleansing diet and eat a lot of vitamins and fruits.This will boost immunity and give the body the strength to fight infections. It is more difficult to cure barley on the eye in a child, because he will constantly rub his eyes with his hands, thereby introducing an infection there.