Ocular Herpes

Herpes simplex keratitis is viral infection of the cornea caused by the herpes simplex virus (HSV). It still remains the most common form of ocular herpes and the leading cause of blindness associated with corneal damage.

Apart from the cornea, the virus is capable of infecting deeper layers of the eye, including the iris, choroid and even the retina and optic nerve, which is why there are different clinical forms of ocular herpes with their own sets of signs and symptoms.

The herpes virus can often be found in association with tuberculosis, pyogenic infection, acanthamoeba and other infectious agents which have a significant impact on the severity of the disease and affect prognosis.

Patients with ocular herpes (be that superficial keratitis or deeper lesions, e.g., keratouveitis) experience debilitating pain, severe photophobia, vision loss of varying degree, and many suffer from constant recurrence.

Ocular herpes may cause severe complications, including

  • hypopyon keratitis,
  • disciform keratitis,
  • corneal leukoma,
  • corneal ulcer,
  • descemetocele,
  • corneal perforation,
  • endophthalmitis,
  • permanent vision loss.

In select cases, the eye cannot be salvaged.

While treatment of a serious condition like ocular herpes is a challenge in and of itself, it is also compounded by additional factors, such as problematic detection, difficult differential diagnosis and a malpractice of managing ocular herpes with corticosteroids, a widely employed strategy in Russia, Europe, USA and several Asian countries.