Herpes simplex keratitis is simply an eye infection involving the cornea that is caused by the herpes simplex virus. It is important to note that the herpes simplex virus does not leave the body after an initial infection. It stays in a dormant phase in the nerves but it oftentimes reactivates and triggers further symptoms.
The primary herpes simplex eye infections typically occur among children and cause minor keratoconjunctivitis which involves inflammation of the cornea and conjunctiva. The initial infection resolves without treatment. Nevertheless, if the infection is reactivated, it can involve the cornea significantly and trigger severe symptoms.
What are the indications?
The signs and symptoms of primary herpes simplex eye infection typically resemble common conjunctivitis; thus a verdict of herpes simplex infection is not given.
The indications of reactivation include eye tearing, eye pain, reddening, sensation of a foreign object in the eye and light sensitivity. In rare occasions, the infection worsens and the cornea becomes swollen which makes vision hazy. If the infection recurs more often, the more likely it will result to the formation of deep ulcers, lasting scarring and numbness of the eye surface.
In addition, the herpes simplex virus can also trigger the development of blood vessels onto the cornea and even result to evident visual impairment.
How is it diagnosed
When diagnosing a herpes simplex infection, the doctor examines the eye using a slit lamp. During the assessment, the doctor will place drops in the eyes that contain a yellow-greenish dye called as fluorescein. Take note that the fluorescein dye briefly stains the damage in the cornea in bright green which makes it possible for the doctor to check the impaired area that is not otherwise visible.
Oftentimes, the doctor might decide to swab the infected area in order to identify the virus.
Management
The treatment for herpes simplex keratitis must be started right away. The doctor will prescribe an antiviral eye drop. In some cases, acyclovir which is an antiviral drug can be taken orally or intravenously.
As for deeper infections that cause significant inflammation, it requires corticosteroid drops and those that dilate the eyes such as atropine or scopolamine.
Occasionally, to hasten the healing process, the doctor will carefully swab the cornea using a soft-tipped cotton applicator to get rid of the infected and damaged cells.