Herpes of the cornea of ​​the eye is treated in a hospital. Herpes on the eyes: causes, symptoms, photos, treatment methods. How the virus behaves during various forms of infection

Herpes on the eye is an infectious disease of the organs of vision that occurs due to pathogenic microflora entering the mucous membrane of the eye. Herpes is a virus that, once it enters the body, remains in the blood forever, and it is not possible to get rid of it. The disease may not make itself felt for a long time, but once the immune system weakens, the virus will begin to manifest itself. The rash can occur on any part of the body where there are mucous membranes: on the lips, genitals, in the eye.

What are the reasons for the appearance

Since the virus, once it enters the body, remains there forever, there are a number of factors that provoke the rapid growth of the virus:

• severe hypothermia of the body;
• colds;
• decreased immune system;
• improper diet, diet;
• prolonged use of antibiotics;
• infections;
• influence of stressful situations.

Herpes is a virus that can be transmitted from an infected person to a healthy person in various ways. Pathogenic microflora is transmitted by air and droplets, during intimate intimacy without the use of protective equipment, and when sharing household items with an infected person. It is enough to wipe your face with a towel that was previously used by a person with the virus in the blood to become infected. For this reason, it is strictly forbidden to let any stranger use your household items, especially cosmetics.

There is also a congenital form of the disease.

The route of infection is vertical, which means that the disease is transmitted to the child from an infected mother during childbirth. The appearance of herpes on the organs of vision may occur due to the presence of this virus on other organs. Often the person himself is to blame for the development of ocular herpes due to failure to observe personal hygiene rules. It often happens that if there is herpes on the lips and when topical drugs are applied to it, a person then does not wash his hands, and when applying makeup or scratching the eye, the virus is transferred to the organ of vision, provoking the appearance of the disease on the cornea, under the eye, on the eyelid .

How does the disease manifest itself?

Signs of the disease depend on which part of the eye the pathogenic virus appears in. In addition to acute symptoms during infection, pain and discomfort are also present during healing. Ocular herpes (ophthalmoherpes) has the following general symptoms:

• the appearance of bubbles;
• erosive plaque;
• crust formation;
• burning;
• tingling feeling;
• redness of the eyelid;
• spread of bubbles and crusts beyond the eye - onto the forehead, cheeks;
• swelling of the eyelids;
• hemorrhage;
• pain;
• cloudiness of the pupil.

Herpes of the eye is divided into the following types: herpes zoster, follicular, catarrhal, vesicular ulcerative. Each form of the disease has its own special features of the course and symptomatic picture. Herpes zoster on the eye, the symptoms of which differ in their intensity, are manifested by a gradual increase in pain not only in the eye, but also in the tissues surrounding the organ of vision.

This is due to the fact that when pathogenic microflora spreads, the trigeminal nerve is affected.

In addition to pain, the patient experiences an increase in body temperature and general health worsens. Bubbles that appear on the mucous membrane of the eye, on the eyelids, are filled with a transparent liquid. The shingles spread to the forehead, eyebrows, and herpes appears under the eye. There is an increase in nearby lymph nodes. Shingles type of the disease, in most cases, affects only one side.

Follicular herpes is characterized by a slow increase in the intensity of the symptomatic picture. The eyes gradually turn red, and a small amount of fluid is released from the corners. Symptoms such as fever, general weakness, itching and burning are absent. Catarrhal ophthalmoherpes symptoms are more aggressive and are characterized by the rapid spread of the virus around the eye. Glasuvesicular-ulcerative herpes has the standard symptoms for this virus - blisters with contents, itching, crust formation.

Possible complications

Herpes on the eyelid, despite the widespread spread of the virus and the large number of infected people, is a rather dangerous disease, which without timely treatment can cause the development of severe eye pathologies. One of the diseases caused by the herpes virus is keratitis. This ophthalmological disease manifests itself in the form of severe redness of the eye, swelling, and the spread of herpes lesions. Keratitis complicated by herpes leads to decreased sensitivity of the cornea. Keratitis against the background of herpes is expressed in the rapid spread of vesicles located on the nerve endings of the cornea of ​​the eye.

With the development of a disease, the treatment of which is delayed by the patient himself, trying to use medications, it can provoke another complex eye disease - iridocyclitis, which, depending on the severity of the symptomatic picture, occurs in acute and subacute forms. It is necessary to treat iridocyclitis immediately, since the disease quickly degenerates into a chronic, sluggish state. Iridocyclitis, complicated by ocular herpes, has symptoms such as severe acute pain, rapid growth of blisters with serous contents. Herpes and iridocyclitis have an extremely negative effect on vision, which rapidly declines if a person does not seek medical help in a timely manner.

In cases where the treatment of ophthalmoherpes was incorrect or incomplete, there is a high probability of developing such a dangerous pathology of the visual organs as necrosis (death) of the retina. Retinal necrosis due to herpes eye disease most often occurs in people with a pathologically weakened immune system in the presence of HIV and AIDS.

Signs of the disease are a sudden decrease in visual acuity up to its complete loss; first, the pathology affects 1 eye, and therefore spreads to the second.

Multiple inflammatory foci appear, which over time lead to rapid detachment of the retina, and an infiltrate of the glass body of the eye occurs. Without timely medical care, retinal necrosis with herpes leads to complete loss of vision.

Diagnostic methods

Possible complications of the visual organs that arise due to the development of ocular herpes are caused by the fact that patients do not consult a doctor on time, preferring treatment with folk remedies. Only a doctor can prescribe effective treatment based on the type of disease, the severity of its symptomatic picture and the depth of damage to the mucous membrane. For this purpose, comprehensive diagnostics are carried out.

First of all, the patient is examined by a doctor. It is not difficult for a doctor to make a diagnosis of herpes based on the present symptomatic picture.

The presence of blisters with liquid contents, burning, itching and pain are pronounced signs of ocular herpes.

To clarify the type of pathological process, the presence of possible complications in the early stages of development and the depth of damage to the visual organs by the virus, a number of medical tests are carried out, and various diagnostic techniques are used.

Visometry is a diagnostic method that allows you to detect the cause of vision loss and diagnose retinal necrosis in the early stages of the development of the pathological process. Biomicroscopy with staining - the introduction of a special dye, fluorescein, allows you to identify the depth of damage to the mucous membrane.

To identify foci with infectious pathogenic flora, which may be located under the mucous membrane and affect the fundus of the eye, an eye examination using a Goldmann lens is used.

Eye herpes, which spreads to both eyes at the same time, may not have specific symptoms at the initial stages, and therefore it can be confused with a number of other infectious eye diseases, in particular, conjunctivitis, therefore, without a thorough diagnosis and laboratory tests, it is quite difficult to quickly and effectively cure herpes . To determine the type of pathogenic microflora that caused the symptomatic picture, a blood test is performed to determine the concentration of leukocytes and erythrocytes, indicating the severity of the inflammatory process.

The most effective diagnostic method for determining herpes on the eye is virology, a technique for growing a pathogenic virus on chicken eggs or on specially created nutrient media. Despite the maximum information content of this laboratory analysis, it has 2 disadvantages - high cost and long waiting time for results (3 weeks).

Features of treatment

Before treating herpes on the eye, it is necessary to undergo a thorough diagnosis, the results of which will help the ophthalmologist select effective medications. To relieve painful and unpleasant symptoms, local spectrum medications - ointments - are prescribed. Advantage in the treatment of clinical manifestations of herpes is given to Acyclovir ointment. You can use it for no more than 14 days; if during this time there is no improvement in your well-being, you must tell your doctor to change the drug.

In order to dry the bubbles with liquid contents, it is recommended to use dyes - brilliant green, iodine, fucorcin.

With a pronounced symptomatic picture and severe pain, which is observed with herpes zoster, a blockade is performed. The patient is prescribed anti-inflammatory and analgesic drugs. To speed up the healing of moist herpes blisters and normalize the patient’s general condition, physiotherapy procedures are prescribed - ultraviolet irradiation, UHF.

Treatment of ocular herpes is complex and lengthy and should only be carried out under the supervision of a doctor. Even if this is not the first time that a person has had ocular herpes, and he is already relatively familiar with what needs to be done, diagnosis and consultation with a doctor is mandatory. Frequent ocular herpes increases the risk of complications. Along with suppressing the pathogenic virus and carrying out symptomatic therapy, the patient is prescribed immunostimulating medications to increase the protective functions of the immune system and reduce the likelihood of relapses in the future.

Herpes under the eyes, the treatment of which does not give a positive result during the first two weeks, requires treatment with antibiotics, which are prescribed individually, depending on the type of pathogenic flora.

If the cornea is infected by a virus, antibiotics are prescribed immediately.

Children are treated differently. Antibiotics are prescribed to young patients only in the case of a pronounced symptomatic picture and a high risk of complications. In the early stages of development of ocular herpes, children are prescribed the drugs Viferon (suppository form) and Oftalmoferon (eye drops). To achieve the fastest results, these drugs are used in complex therapy. The dosage and methods of use in a child are prescribed by the attending physician. It is strictly forbidden to choose eye drops on your own to treat ocular herpes.

Prevention measures

To reduce the risk of relapse, it is enough to follow simple preventive measures, which are mostly aimed at restoring the protective functions of the immune system.

You need to dress only for the weather, excluding hypothermia - the main factor that provokes the appearance of herpes in the eyes and other parts of the body. Avoid stress, mechanical and chemical injuries to the eyes. Adequate rest, both moral and physical, is the key to preventing the herpes virus from developing. How to treat ocular herpes? Doctors recommend that people infected with the herpes virus regularly undergo vaccination to reduce the risk of recurrence of herpes. This method of prevention is especially useful in the autumn-winter period, when, due to a lack of vitamins and insufficient sunlight, the protective functions of the immune system are reduced. A course of preventive vaccine is carried out 2 times a year. The essence of the technique is the intradermal administration of a herpes vaccine.

It is necessary to seek medical help when the first signs of lip herpes appear. Patients who have repeatedly encountered this disease are able to identify the initial symptoms - a slight feeling of discomfort, the appearance of frequent itching in the eyes.

Ocular herpes is a dangerous ophthalmological disease, which, in addition to painful, unpleasant symptoms, can lead to very serious consequences.

Despite the high probability of relapse, it is possible to prolong remission as much as possible. Prevention is simple: do not overcool, treat infectious diseases in a timely manner, monitor the state of the immune system and carefully observe hand and face hygiene, avoid bodily and close contact with infected people who have an acute stage of ocular herpes.

Herpes in the eyes must be treated so that new rashes appear as rarely as possible.

Herpes on the human body can manifest itself in different ways. The most dangerous option is herpes in the eyes. Ophthalmoherpes is not dangerous in itself, its consequences are much more terrible - keratitis, that is damage to the cornea, leading to weakened vision and even blindness. It is the herpes virus that is the most common cause of keratitis, especially if it is recurrent. Without proper treatment, herpes affects more and more eye tissue, which means vision loss becomes inevitable.

Causes of ophthalmoherpes

More often The cause of herpes on the eye is the herpes simplex virus or herpes zoster virus(chickenpox), although the herpes virus can cause herpetic eye lesions 2 types(genital), cytomegalovirus and herpes virus 6 types(causing roseola). All of the listed types of virus are integrated into the cells of the body, where the formation of new viral particles occurs.

The note

The virus enters the body through the oral mucosa, respiratory system or sexual intercourse. You can become infected with herpes by sharing the same dishes or towel with a sick person. The virus first lives in epithelial tissue, then moves into the blood and lymph, thanks to which it spreads throughout the body.

For the time being, the body resists viruses, as it is protected by the immune system. If the virus enters the mucous membrane of the eye, the interferon produced by the mucous membrane prevents it from spreading. Also, the tissues of the eye are protected by immunoglobulins contained in the tear fluid. The virus that causes herpes in the eyes can “sleep” in the nerve ganglia for a very long time.

If for some reason the immunity decreases, the herpes virus strengthens and manifests itself in the form of ophthalmic herpes. A decrease in immunity occurs as a result of the following situations:

• hypothermia;
• prolonged exposure to the sun;
• infectious diseases;
• stress;
• eye injuries;
• the use of certain medications (immunosuppressants, cytostatics, etc.);
• pregnancy.

The virus, “sleeping” until this moment, “wakes up” and comes to the surface in the form of characteristic bubbles. This type of disease development is called endogenous. The exogenous route is when infection occurs directly through herpes blisters - the liquid from them, containing viruses in high concentrations, enters the mucous membrane of the eyes, resulting in ophthalmoherpes infection occurs. This route is especially typical for children who play together and can infect each other through direct touch.

Herpes on the eyes - symptoms

Eye herpes can be confused with allergies or diseases caused by bacteria ( conjunctivitis, blepharitis or bacterial keratitis). All inflammatory eye diseases - including herpes - are accompanied by the following symptoms:

• soreness;
• distortion and impairment of visual acuity, especially at dusk;
• photophobia;
• lacrimation.

Local symptoms may be supplemented by general ones - headache, nausea, swollen lymph nodes and fever.

Specific symptoms of herpes on the eyes, by which it can be distinguished from other diseases:

• severe burning and itching of the skin on the eyelids and around the eyes;
• the appearance of bubbles with liquid inside, which then burst and ulcerate.

Forms of herpes

Ophthalmoherpes differs from other types of herpes in a large number of manifestations, and symptoms during relapses can vary greatly. Depending on the damage to the tissues of the eye, the following main forms of herpes on the eyes are distinguished:

How to identify herpes

The symptoms of eye colds, as herpes is often called, are similar to those of other diseases. Makes an accurate diagnosis ophthalmologist, who performs a slit-lamp examination, which reveals ulcerations and other corneal lesions, as well as inflammation of the eye vessels. Also in hospital settings scraping of cells from the affected mucous membrane or skin is carried out, which is studied using a fluorescent microscope.

The note

Another diagnostic method is an enzyme immunoassay, which can detect the presence of antibodies to the virus.

The listed diagnostic methods are required for damage to the cornea and blood vessels. As a rule, herpetic lesions of the mucous membrane of the eyes and skin of the eyelids are noticeable even without a medical examination. Herpes on the eyelid is characterized by multiple rashes in the form of small bubbles with lymph - a liquid that gradually becomes cloudy. The blisters are painful and very itchy. If you scratch the sore, it spreads even more.

How dangerous is herpes in the eyes?

If herpes is localized on the surface, then adequate treatment can get rid of it without negative consequences. If deeper tissues are affected, the following consequences are possible:

• corneal clouding;
• decreased visual acuity;
• retinal hemorrhages;
• retinal detachment (complete or partial);
• cataract;
• glaucoma;
• retinal death;
• complete loss of vision.

Serious vision problems do not arise, of course, from primary herpes, but if it is not treated, it will recur, each time affecting the deeper structures of the eye, which will lead to irreversible consequences.

Herpes on a child's eye

In childhood, risk factors for the manifestation of herpes in the eyes are hypothermia, overheating, excessive exposure to the sun, stress, hormonal changes in the body, vaccinations, and microtrauma to the eye. Children often ophthalmoherpes is accompanied by herpetic rashes on the lips. In addition to the appearance of blisters on the eyelids and lips, you need to pay attention to the following symptoms:

• redness of the eye;
• lacrimation;
• itching of the eyelids;
• Pain in the eyes;
• feeling of sand in the eyes.

All these symptoms indicate the development of herpes in the eyes. In this case, you should immediately consult a doctor. As first aid before seeing a doctor, you can use Oftalmoferon drops to relieve discomfort and suppress the activity of the virus.

Attention

Self-medication for herpes in children is strictly forbidden! Incorrectly selected therapy or lack of treatment will lead to serious problems, including loss of vision.

Particular attention should be paid to the prevention of herpes in front of a child. To do this, you need to lead a healthy lifestyle, follow a daily routine, get enough sleep, not be overcooled and not overworked. It is worth taking vitamins seasonally; special complexes for the eyes containing blueberry extract are especially useful.

Treatment of herpes in the eyes

How to treat a cold on the eye? It depends on the form of the disease. If only superficial tissues are affected, there will be enough medicine to relieve discomfort and suppress the activity of the virus.

There are four types of drugs that are used in combination to treat herpes on the eyes:

• antiviral;
• immunomodulatory agents;
• specific immunotherapy drugs (herpes vaccine);
• symptomatic remedies: vitamins, painkillers, decongestants, etc.

If the deep tissues of the eye are affected, Only surgery will help: coagulation(thermal or laser), keratoplasty and other types of operations that will localize or remove the affected tissue.

Antiviral agents for the treatment of herpes on the eyes

The mucous membrane of the eye is different from the skin, therefore, to apply medications to it, forms are used that do not irritate the mucous membrane. To suppress the activity of the herpes virus, eye ointments and drops, as well as tablets and injections, are used.

The most effective drugs for treating herpes on the eyes:

• Acyclovir– in this form of the disease it is taken orally in the form of tablets (0.2 grams up to 5 times a day), and ointment is also applied topically. You can use Zovirax or Virolex;
• Valaciclovir– for the treatment of ophthalmoherpes, only tablets are used, for example, Valtrex 0.5 grams twice a day. Once in the human body, valacyclovir is converted into acyclovir, which is most active against the herpes virus;
• Oftan-IDU (idoxuridine, keratsin, etc.)- This is a special drug for the treatment of herpes in the eyes. Available in the form of drops containing a thymine analogue. The drug prevents the virus from multiplying and suppresses its activity. Drops are instilled frequently - every hour. With prolonged use, the drug can lead to damage to the cornea;
• TFT (trifluorothymidine)– another drops similar to Oftan-IDU, but having a less toxic effect;
• Vidarabin– gel against ocular herpes, which is applied to the conjunctiva up to five times a day;
• Tebrofen, riodoxol, bonaftone- ointments against herpes, they are applied to the skin of the eyelids affected by herpes and placed behind the eyelids.

Immune drugs in the treatment of ophthalmoherpes

Herpes is a sign of decreased immunity, which is why immunocorrection is carried out for herpetic rashes, for which interferon and immunoglobulin preparations are used.

Immunoglobulins for nonspecific therapy for herpes - interlock and interferon-alpha, as well as reaferon:

1. Interlock and interferon-alpha– these are drugs in the form of drops based on donor blood, which contain leukocyte human interferons. They modify cell membranes, so that the virus does not penetrate them.
2. Reaferon– a synthetic preparation of a bacterial nature containing human interferon. A product in the form of drops for instillation into the eye. It can also be injected into the area around the eye.

In addition to immunoglobulin preparations, interferon inducers are used:

• poludan;
• levamisole;
• amiksin;
• lycopid;
• cycloferon;
• Thymalin.

These drugs can be taken as tablets and also as injections, in some cases injections are given periocular, that is directly into the eye. Thanks to taking these drugs, the production of the human body's own interferon increases. And while taking immunoglobulins can cause allergies, interferon inducers have virtually no side effects.

Herpes vaccine

A herpes vaccine has been developed from inactivated herpes simplex and herpes type 2 viruses. The vaccine is administered for recurrent ophthalmoherpes strictly during the period without exacerbation of the disease, the vaccine can be repeated no earlier than six months later. Vaccines on the market from different manufacturers, the most famous of which are Vitagerpevac and Gerpovax made in Russia, as well as Gerpevak made in Belgium.

Also, for specific immunocorrection for herpes in the eyes, antiherpetic interferon is used in the form of an ointment, which is applied topically. Herpferon consists from recombinant interferon and 3% acyclovir Thus, the drug blocks the action of the virus and protects healthy cells from it.

Concomitant medications

Herpetic eye infection is often accompanied by pain and cramping. Used to relieve spasms mydriatics (Atropine, Irifrin and others). Also, in case of serious damage to eye tissue, it is prescribed antiseptics and antibiotics.

Bacterial infections are often added to herpes. Antiseptics and antibiotics are used to treat this complication. Most effective for treating concomitant infections cephalosporins and fluoroquinolones. Antibiotics are administered by injection or in the form of drops; tetracycline and erythromycin ointment are also used.

Attention!

Antibiotics should not be taken without a doctor’s prescription and bacteriological examination!

Herpetic eye lesions - especially complex ones - are treated with a large number of drugs, which can cause an allergic reaction. To warn her, usually antihistamines such as Suprastin, Tavegil are prescribed and so on.

Prescribed for a speedy recovery vitamin preparations, as well as agents that increase blood supply to the eye. These are nicotinic acid, vitamins A, C, group B, pentoxifylline.

Folk remedies

The mucous membrane of the eye is a very delicate tissue, which is undesirable to be exposed to irritating substances. Effective A folk remedy for the treatment of herpes on the eyes is garlic juice., but I can’t recommend it to everyone. The individual reaction of the eye can be unpredictable.

It is better to use softer means:

• infusion of marshmallow flowers - for washing the eyes, the infusion is prepared from 2 tablespoons of dried flowers, brewed with a glass of boiling water;
• honey with water in a ratio of 1 to 2 – drop into the eyes;
• a compress of fresh dill juice relieves inflammation;
• gruel of grated fresh potatoes - this lotion relieves pain and burning;
• infusion of rose hips - used for eye washes and compresses, relieves inflammation and pain;
• aloe juice diluted with water (1:10) is dropped into the eye and used for compresses.

It is worth considering that folk remedies are designed to alleviate the patient’s condition, but they do not cure the disease. They cannot resist the virus. Therefore, you cannot use only folk remedies.

Prevention of herpes in the eyes

Herpes in front of the eyes is dangerous due to its frequent relapses. Therefore, it is important to prevent the virus from spreading.

To prevent herpes from being transmitted to other people, it is important:

• maintain personal hygiene,
• use individual dishes and towels,
• Avoid direct contact with the patient.

The note

A person prone to manifestations of herpes in the eyes should lead a healthy lifestyle, avoid hypothermia or overheating in the sun, and not overwork.

To strengthen the immune system, and therefore to prevent herpes, walking in the fresh air and physical exercise, hardening, proper nutrition and taking multivitamins are useful. At the first manifestations of herpes in the eyes, you should consult a doctor and select adequate therapy to prevent the development of the herpes virus in the body and complex eye lesions.

Herpes on the eye is a viral disease that affects ninety-five percent of the population. The herpes virus is easily transmitted through airborne droplets, contact and sexual intercourse.

The disease is both congenital and acquired. But in any situation it can take on a chronic form, which can no longer be cured completely.

Herpes may not manifest itself for a long time and not show any symptoms. But there are many factors that can trigger this process. These include the following.

• Hypothermia.
• The use of prostaglandins and cytostatics.
• The period of bearing a baby.
• Weakened immune function.
• Long exposure to the sun.
• Injury to the visual organ.
• Stressful situations.
• Disorders in the digestive system.
• Unbalanced diet.
• Long-term use of antibiotics.

Symptoms of herpes under the eye

The herpes zoster type occurs against the background of inflammatory processes of the first branch of the trigeminal nerve. This leads to pain and increased body temperature. If there is no treatment, then other symptoms are added in the following form.

• Swelling on the eyelid.
• Photophobia and increased tearfulness.
• Redness of the eyeball.
• Sensation of a foreign body in the eye.

A day after this, bubbles appear on the skin, which gradually become cloudy and become covered with a red crust. After recovery, scars often remain.

Rashes form on the upper eyelid and eyebrows. Herpes under the eye occurs when the second branch of the trigeminal nerve is affected, which occurs in the rarest situations. The main symptom is usually enlarged lymph nodes and painful sensations when touched.

Most symptoms are similar to an allergic reaction or bacterial infection of the eyes. If the neuritis has a herpetic form, then a painful sensation occurs in the orbit, the visual field narrows, a blind spot appears and pain is felt when turning the head. In some situations, nausea and vomiting may occur.

If you ignore the symptoms, complications may appear in the form of double vision, the appearance of sparks and lightning in front of the eyes, fogginess and distortion of nearby objects.

Types of herpes under the eye

Herpes above the eye is usually divided into three main forms.

1. Follicular type. The process is sluggish. The main symptom is only redness of the eyelids.
2. Catarrhal type. It is characterized by an acute course of the disease, where the symptoms are pronounced.
3. Vesicular-ulcerative type. In this situation, rashes appear in the form of blisters, which subsequently heal without scarring.

Herpes above the eye can cause unpleasant consequences.

1. Keratitis. The main symptoms include blepharospasm, severe pain, photophobia and increased tearing. Rashes appear on the cornea. If they burst, they will cause discomfort and pain. Treatment lasts long enough that it can lead to clouding of the cornea.
2. Iridocyclitis. This disease leads to swelling of the iris and congestion, resulting in increased intraocular pressure and pain.
3. Acute necrosis of the retina. This disease occurs in people suffering from immunodeficiency. Characterized by symptoms such as loss of visual function for several months due to retinal detachment.

Diagnosis of herpes under the eye

The first step is for the patient to seek help from a doctor. Based on the examination and complaints of the patient, he will prescribe an examination. It includes the following items.

• Visiometry. This method will reveal decreased visual function, especially if there is optic neuritis or corneal infiltration.
• Analgizemetry. Helps detect decreased susceptibility of the cornea, which is caused by the herpes virus.
• Biomicroscopy.
• Ophthalmoscopy.

The symptoms of the disease are not specific. Therefore, herpes under the eye can only be detected through laboratory examination. Using the fluorescent antibody method, the presence of antibodies to the herpes virus is determined. They take it in the form of a scraping from the conjunctiva of the eye. The patient's immune function and virology are also examined.

Treatment of herpes under the eye

Herpes under the eye is treated by treating the affected surface and strengthening immune function. To do this, you need to lubricate your eyelids with ointment, the active ingredient of which is acyclovir. If there are rashes on the eyebrow area, then you need to use a product with a five percent active substance content. It is worth smearing at least four times a day for two weeks.

It is also recommended to take Acyclovir tablets five times a day. The course of treatment is approximately ten days. After this, you need to take immus stimulants. When herpes under the eye has just appeared, it is worth observing hygiene measures. To exclude the spread of the disease to the mucous membrane, do not wet the eye.

To avoid infection of healthy areas of the visual organ, antiviral ointment can be applied as needed. To relieve pain, a novocaine blockade is performed. To act directly on the virus, it is necessary to instill Ophthalmoferon eye drops. Also, to cure herpes above the eye, you should take B vitamins.

The appearance of herpes above the eye in children

Herpes above the eye occurs not only in adults, but also in children. Often in a child, the disease manifests itself as a result of infection of the visual organs and mucous membranes of the mouth from unwashed hands. Also, herpes under the eye can occur due to wiping with a regular towel, which was previously used by a patient infected with the virus.

According to statistics, in fifty percent of cases, children under three years of age are infected. Herpes above the eye occurs due to the first type of infection, which is referred to as a cold sore on the lips. The infection first spreads to the mucous membrane of the lips and mouth. When a child touches the infection sites with his hands, he carries the virus to the conjunctiva and cornea of ​​the visual organ.

Types of childhood herpes

Depending on the location of the lesion and its depth, herpes under the eye can be divided into several types.

1. Herpes keratitis. Involves damage to the cornea of ​​the eye.
2. Stromal keratitis. The deep layers of the cornea are damaged, resulting in scarring.
3. Retinitis of the herpes type. The virus passes into the eye tissue and infects the retina.
4. Iridocyclitis. The iris of the eye is affected.

Treatment of herpes in children

To cure herpes under the eye, you should seek help from a doctor. If this is not done on time, the child may lose full visual function. Before coming to the doctor, you can take preventive measures in the form of instilling Ophthalmoferon drops. Such a local remedy will help prevent the virus from penetrating into the deep tissues of the visual organ. Treatment includes antiviral drugs in the form of tablets and ointments, the use of non-specific immunoglobulins and vaccination. Additional treatment also includes taking antihistamines and antiseptic therapy. If herpes over the eye is severe, then surgical intervention in the form of coagulation or keratoplasty is prescribed. Herpes under the eye in a child can be treated for quite a long time, up to four weeks.

Preventive measures to prevent the appearance of herpes under the eye

To prevent herpes from occurring above the eye, you should follow several preventive recommendations.

1. If you already have herpes under the eye, then you should remember that it can get worse. Therefore, it is necessary to strengthen immune function. This is especially true for young children. You should also avoid colds and hypothermia, because herpes over the eye is a complication of them.
2. Each family member should have individual things: a towel, dishes, a brush.
3. The rule for the female half of the population is that you cannot use other people’s cosmetics.
4. To prevent herpes under the eye from appearing in the unborn baby, a pregnant woman needs to be treated with Miramistin before giving birth.
5. If herpes appears regularly under the eye, then it is worth getting vaccinated.

This condition can be caused by:

• hypothermia;
• long-term use of antibacterial drugs;
• sudden climate change;
• disruption of digestive processes;
• chronic mental and physical fatigue.

The body's defenses are reduced during exacerbations of systemic diseases and during stress. During pregnancy, there is also a significant decrease in immunity. This is a vital necessity; in this way, the expectant mother’s body tries to prevent rejection of the maturing embryo. For many, the infection does not manifest itself in any way. The person does not even suspect that he is a potential threat to others. This is the insidiousness of herpes.

Routes of infection

If the carrier has herpes in a latent state, the person is not dangerous to others. The source of infection is the one who has characteristic symptoms of infection, the one whose herpes is in the active phase, but the course of the infection is asymptomatic.

Symptoms of herpes in the eyes

In adults and children, the appearance of herpes in the eyes causes the same symptoms. First, the patient begins to feel a slight tingling, burning and itching in the infected area of ​​the skin or mucous membrane. Tears appear, the eyeball turns red, the palpebral fissure narrows, and at dusk, visual acuity is lost. Convulsive twitching of the eyelids and photophobia appear. Headaches occur and cause severe weakness. Sometimes there is a slight increase in body temperature.

If the infected area is on the skin around the eyes, on the eyelid, it swells and redness appears. After a day, a group of vesicles filled with serous fluid forms at this site. It contains a huge number of living viral particles. An increase in the volume of the substrate leads to the bubbles opening on their own and their contents pouring out. At this moment, the patient poses the greatest danger to others.

It is believed that if several cases of exacerbation occur during the year (more than four), it is imperative to seek help from an immunologist and, together with him, correct the immune system.

Possible complications

The appearance of characteristic symptoms cannot be ignored: the course of the infection can provoke various complications. For example, if lesions appear on the surface of the eyeball, acute retinal necrosis may develop. It is the most common cause of complete blindness. As a rule, one eye is affected first, and after two months the second is also involved in the process. Initially, the lesions appear on the periphery, then merge and provoke retinal detachment. In 50% of cases, patients completely lose their vision.

Another dangerous complication is iridocyclitis (anterior uevitis). Its development is indicated by pain that occurs when pressing a finger on the cornea of ​​the eye. Visible vessels dilate and become engorged with blood, the iris becomes red or green with a rusty tint. In this case, the iris pattern itself merges and becomes indistinguishable. In this case, the patient complains of a feeling of “veil” before the eyes. The occurrence of such a complication can also provoke vision loss.

Herpes can cause inflammation of the cornea (keratitis). With its development, blepharospasms, photophobia are observed, the transparency of the cornea decreases, and shine is lost. The outcome is decreased vision, a thorn.

Lesions of the skin of the eyelids and mucous membranes of the visual organs make it possible to make a correct diagnosis without the use of instrumental examination methods. If infection with herpes has caused damage to the cornea or blood vessels, then to clarify the diagnosis, the ophthalmologist must examine the patient using a slit lamp. He scrapes the skin or mucous membrane of the affected area and sends the material for laboratory testing. There are methods that allow you to identify the causative agent of the infection and understand what type of herpes is inside the body. Further treatment of ophthalmoherpes is carried out after analyzing the answers from laboratory tests.

Treatment tactics

Treatment tactics are also developed taking into account the existing clinical manifestations. Therapeutic regimens necessarily include antiviral and immunomodulating drugs, antihistamines; ointments, drops and gels are actively used for local treatment.

To eliminate clinical symptoms, the following are prescribed:

• antiseptic drops (“Miramistin”);
• anti-inflammatory drops (“Naklof”);
• antihistamine drops (“Opatanol”);
• antibacterial drops (Tobrex).

The last group of drugs is prescribed when the course of herpes is provoked by the addition of a bacterial component. To strengthen the immune system, Polyoxidonium suppositories or Cycloferon injections are prescribed, and loading doses of B vitamins and ascorbic acid are required.

The duration of treatment is determined by the ophthalmologist; on average, it lasts 3-4 weeks. If damage to the deep layers is detected, specific therapy is carried out aimed at preserving vision.

Herpes during pregnancy

The appearance of herpes on the lips or eyes with a favorable course of infection rarely causes dangerous complications. A pregnant woman may encounter the virus for the first time while carrying a child, and she may experience an exacerbation of the chronic form. So, primary infection of the genital organs in the first trimester is considered undesirable. It can cause infection of the fetus and provoke the following complications:

• spontaneous miscarriage;
• fetal development disorder;
• herpetic lesions of the tissues of the nervous system, eyes, oral cavity;
• damage to amniotic fluid (fetal hypoxia);
• intrauterine fetal death.

Since during pregnancy there is a sharp decrease in immunity, the course of ophthalmic herpes is always much more severe than usual, it is often accompanied by fever and provokes blood circulation disorders. Therefore, deep damage to the tissues of the visual organ quite often occurs, and this is also very dangerous for the expectant mother herself. That is why it is so important to immediately contact an ophthalmologist when the first symptoms appear and, together with him, under the supervision of a gynecologist managing the pregnancy, treat the infection.

Herpes virus in children

Nature has taken good care of protecting the organs of vision: the fluid of tears contains immunoglobulins that can prevent the penetration and spread of viral pathogens. But with a sharp decrease in immunity, the properties of protective barriers weaken.

In children and adolescents, herpetic infection occurs in the same way as in adults; forms are often diagnosed in which damage to the deep layers of the visual organs is observed. Self-medication in this case is unacceptable. It is important to immediately contact an ophthalmologist if characteristic symptoms appear. Before meeting him, you need to provide first aid to the child: go to the pharmacy and buy Ophthalmoferon drops, drop them into the affected eye, two drops four times a day. The doctor will make further appointments after examination and laboratory tests. When drawing up a treatment regimen, he will necessarily take into account the child’s age, his weight, and the individual characteristics of the course of the infection. If signs of complications are detected, hospitalization may be performed.

After recovery, given the high possibility of relapses, it will be necessary to provide the child with preventive treatment twice a year (in autumn and spring). It consists of taking vitamin complexes (“Strix Kids”, “Blueberry Forte”), and following the rules of proper nutrition. It is important to try to eliminate the occurrence of emotional overload, maintain a sleep-wake schedule, toughen up, instill a love of sports, and dress the child in accordance with weather conditions.

You cannot use shared bath accessories or other people's cosmetics. It is useful to strictly observe the rules of personal hygiene and not touch your eyes with dirty hands. If there are frequent relapses, it is worth getting an antiherpetic vaccine.

From this article you will learn:

• ocular herpes: symptoms and causes,
• herpes on the eye - treatment, photo,
• list of effective drugs.

Primary eye infection with herpes most often occurs in early childhood. The first case of the disease is usually mild and resembles ordinary conjunctivitis (Fig. 1-3). The latter usually resolves quickly without complications and without involvement of the cornea. If the cornea is nevertheless involved, then lacrimation and photophobia are added to the redness of the conjunctiva.

In some cases, in addition to these symptoms, rashes of herpetic blisters may appear on the eyelids (Figure 4-5), i.e. vesicular blepharitis. The resulting blisters burst after a few days, leaving ulcerations that heal without scarring in about 7-10 days. In parallel with this, some “fogging” of vision is possible.

Herpes on the eyelid (blepharitis) –

Primary ocular herpes occurs precisely in early childhood - due to a gradual decrease during this period in the residual amount of antibodies to the herpes virus that were received from the mother during pregnancy. Moreover, if herpes on the eye occurs against the background of a still fairly high level of antibodies in the blood serum, the symptoms are usually mild and may be limited to conjunctivitis.

If against a background of low antibody levels, damage to the eyelids and cornea is possible. Many patients may develop repeated relapses of the disease after a primary infection. According to statistics, in 10% of patients the first relapse occurs within the first year. Unlike primary eye herpes, a chronic recurrent form of the disease can lead to significant damage to the cornea, deterioration and even loss of vision.

Herpes of the eye: causes

There are many types of herpes virus - the so-called herpevirus family. However, only 3 types of herpesviruses cause eye damage. Most often it is herpes simplex virus type 1 (HSV-1), less often – herpes simplex virus type 2 (HSV-2) and herpes zoster virus (HSV-3). Herpes on the eye caused by the HSV-2 and HSV-3 viruses is much more difficult to treat.

After initial infection and recovery, the herpes virus persists in the sensory and autonomic nerve ganglia. This explains why the herpes virus primarily affects the lips, cornea of ​​the eye, oral mucosa and genitals. The fact is that it is in these tissues of the body that a large number of sensory nerve fibers are concentrated. And when immunity decreases, the virus is activated, causing a relapse of the disease.

The herpes virus can enter the cornea of ​​the eye through direct contact with a person with active clinical manifestations of herpes. In addition, you can introduce the virus yourself if you have active or herpetic stomatitis. It is enough to spit on your fingers or touch your lips with your hand, and then rub your eyes. You can even transfer herpes from the lip to the eye area by simply wiping yourself with a towel.

In children -
Herpetic eye lesions develop especially often in children. Young children constantly put their hands in their mouths and lick them. And if a child has herpes on the lip, the skin around the mouth or on the mucous membrane of the oral cavity, this virus will definitely end up everywhere, including the eyes. Therefore, it is very important for young children with herpes of the lips to instill special drops into the eyes, for example, Ophthalmoferon.

Repeated outbreaks of ocular herpes –

Repeated cases of the disease usually manifest as epithelial keratitis (damage to the surface of the cornea). Epithelial keratitis is manifested by lacrimation, photophobia, and the feeling of a foreign body in the eye. But the most important diagnostic criterion is the formation of a corneal defect in the form of tree branches (which is why epithelial keratitis is often also called tree-like or serpentine). This form of keratitis usually heals without a trace in 1-2 weeks.

Herpes on the eye: photo of epithelial keratitis

In some cases, herpetic lesions may occur not only on the surface of the cornea, but also on its deeper layers (stroma), which indicates the development of stromal keratitis. The latter is divided into disc keratitis - in this case, the main diagnostic criterion will be the appearance in the cornea of ​​the eye of a disc-shaped area of ​​turbidity and swelling. With disc keratitis, there is no stromal necrosis.

The second form of stromal keratitis is necrotizing keratitis, which occurs with necrosis of the corneal stroma. Visually, areas of necrosis look like a whitish-turbid infiltrate in the corneal stroma (can occur with or without damage to the corneal epithelium). There can be only one large infiltrate, or multiple small infiltrates. The development of such necrosis is usually associated with a pathological reaction of the patient's immune system.

Complaints of patients with stromal keratitis -

• severe pain,
• blurred vision,
• sensitivity to light (photophobia),
• feeling of “sand in the eyes.”

Diagnostics -

The diagnosis is made by an ophthalmologist. As a rule, an examination using a special slit lamp is sufficient, but in controversial cases, a microbiological examination (viral culture) can sometimes be prescribed. It is very important to distinguish eye herpes caused by the herpes simplex virus types HSV-1 and HSV-2 from the HSV-3 virus that causes herpes zoster (which also affects the eyes).

Herpes on the eye: treatment and prevention

Treatment tactics will depend on whether the eye infection is primary or secondary with the herpes virus, as well as on the severity of the symptoms. Herpes on the eye - treatment in a child in the first case of the disease (provided that only symptoms of conjunctivitis are observed) - is possible with the help of the drug Oftalmoferon. Regimen – 1-2 drops 8 times a day (until the symptoms go away). If we are talking about a young child, then in parallel it can be used in the form of candles.

If, in addition to conjunctivitis, herpes occurs on the eyelid, treatment in addition to Oftalmoferon drops should include 5% cream with Acyclovir. Acyclovir cream at 5% concentration can be applied only to the eyelids and skin around the eyes. If epithelial keratitis has developed, then you need to keep in mind that only a special eye ointment with 3% Acyclovir can be applied to the lower eyelid.

With moderate clinical manifestations, the above drugs are enough to cope with new-onset ocular herpes. However, in very rare cases, newborns may have very severe clinical manifestations. In this case, an emergency consultation with an ophthalmologist and treatment with systemic antiviral drugs are needed.

Treatment of repeated outbreaks of herpes –

As we said above, with repeated outbreaks of ocular herpes, epithelial or stromal keratitis develops. With adequate treatment, epithelial keratitis resolves within 1-2 weeks and ends with complete healing. However, in the absence of proper treatment, in approximately 25% of patients, epithelial keratitis transforms into stromal keratitis (which in turn can lead to scarring of the cornea and sometimes even loss of vision).

1. Local treatment –

Epithelial keratitis can be easily treated with local remedies. In Europe and the USA, 2 drugs are approved for this purpose. Firstly - 0.15% Ganciclovir gel (according to the scheme - 5 times a day / i.e. every 3 hours). Secondly, a 1% solution of Trifluridine in the form of drops (according to the scheme - 9 times a day / every 2 hours after waking up). The problem is that these modern drugs are not available to Russians, because... We simply don't sell them.

Therefore, there is only one alternative - this is Acyclovir 3% eye ointment. There is an original drug - Zovirax (Great Britain) - at a price of 280 rubles per 4.5 g tube. Or, as an alternative, you can use an inexpensive Russian-made ointment (manufacturer Sintez, Kurgan) - at a price of 120 rubles per 5 g tube.

Application diagram –
Eye ointment for adults and children is placed in the lower conjunctival sac (behind the lower eyelid) - 5 times a day at intervals of 4 hours. Each time, a 10 mm strip of ointment is used for this. Treatment lasts as long as there are symptoms + another 3 days after healing.

Treatment of stromal keratitis –

For stromal keratitis, topical glucocorticoids may be prescribed. Please note that they cannot be used for epithelial keratitis! But in stromal cases they should be used in combination with antiviral agents. For example, a 1% prednisolone solution can be used. At the first stage of treatment - every 2 hours, with a subsequent increase in the interval - up to 4-8 hours. An alternative drug to prednisolone is 0.1% dexamethasone solution.

You also need to monitor intraocular pressure and, if it increases, prescribe appropriate treatment. To treat concomitant photophobia, a 1% atropine solution or a 0.25% scopolamine solution can be used (both drugs - 3 times a day). Remember that you should never use glucocorticoids without a doctor’s prescription.

2. Systemic treatment –

In some cases, either tablet forms may be prescribed - or acyclovir in the form of intravenous infusions. The effective dosage of acyclovir for children over 2 years of age and adults is 400 mg taken 5 times a day. For children under 2 years old - 200 mg 5 times a day. Valacyclovir is prescribed - 1000 mg 2 times a day. The duration of therapy in each case is 3 weeks (21 days).

Treatment of immunocompromised adults is carried out with an increased dosage of acyclovir up to 800 mg (5 times a day, for 3-4 weeks), or an intravenous form of acyclovir can be used. If the herpes virus is resistant to acyclovir/valacyclovir, famciclovir 500 mg 2 times a day can be prescribed.

Ophthalmic herpes zoster –

Herpes in the eyes can be caused not only by the herpes simplex virus (Herpes simplex, types HSV-1 and HSV-2), but also by the herpes zoster virus type HSV-3, which causes herpes zoster (synonymous with herpes zoster). When the herpes zoster virus worsens, the eyes can also be involved in the process, and herpetic eruptions occur along the 1st branch of the trigeminal nerve.

The very first symptom that appears in the prodromal stage of the disease (i.e., before the onset of herpetic eruptions) is an indication at the tip of the nose. In the acute phase of the disease, the symptoms are usually very pronounced, and also appear as rashes on the eyelids, the skin around the eyes, the skin of the forehead, and also very often on the tip of the nose. There may be very strong pain in the forehead, severe swelling of the eyelids, and photophobia.

In more than half of all cases, inflammation of all tissues of the anterior and sometimes posterior parts of the eye occurs. Eye herpes caused by Herpes Zoster can be severe and is often accompanied by scarring of the cornea. The consequences may include cataracts, glaucoma, chronic uveitis, corneal scarring, postherpetic neuralgia, etc. (all these complications impair vision).

Diagnostics -

The diagnosis is made based on the characteristic rash on the forehead, tip of the nose and eyelids, as well as on the results of an eye examination. Traces of herpes zoster in the past in the eye area can be indicated by atrophic hypopigmented lesions that have arisen at the site of past herpetic eruptions on the forehead. Herpetic lesions of the forehead and skin around the eyes, which have not yet spread to the eyeball, indicate a high risk and require urgent consultation with an ophthalmologist.

Treatment -

The basis of treatment for ophthalmic herpes zoster is tableted antiviral drugs (acyclovir, valacyclovir, famciclovir). In some cases, it is advisable to use local glucocorticoids, for example, 1% prednisolone solution or 0.1% dexamethasone solution.

Treatment with acyclovir in children over 2 years of age and adults should be carried out according to the regimen - 800 mg orally 5 times a day (for 7-10 days). Use in adults: famciclovir - 500 mg 3 times a day (7 days in total), valacyclovir - 1000 mg 3 times a day (7 days in total). It has been noted that the pain syndrome is significantly less when using valciclovir and famciclovir, but these drugs will be much more expensive.

In patients with a weakened immune system or neurological complications requiring hospitalization, intravenous acyclovir is usually used at a rate of 10 mg/kg body weight, infusion every 8 hours (for 7-10 days). If there is no effect of treatment with acyclovir in such patients, Foscarnet is used at the rate of 40 mg/kg, every 8 hours until all lesions are healed.

Prevention of herpes –

• try not to come into contact with people who have active herpetic rashes,
• strengthen your immunity,
• wash your hands regularly,
• if you have herpes on your lip, wash your towels regularly, and also change your pillowcase after each use (especially in children), otherwise there is a high risk of herpes spreading from the lip to the eye area,
• when a herpetic form of stomatitis occurs in children, it is advisable to prophylactically instill Oftalmoferon into the eyes (since they very often lick their fingers and then rub their eyes with them),
• do not use any personal belongings of a person with herpes,
• Use sunscreen on your face and lip balm containing zinc oxide if you plan to be in the sun for long periods of time.

For patients with severe, recurrent outbreaks of herpes, vaccination may be an option. The Russian vaccine “Vitagerpavak” is intended for the prevention of herpes types 1 and 2. This is a new vaccine, and it is still difficult to say for sure the degree of its effectiveness, but for patients with frequent outbreaks, we would recommend it as one of the preventative options. We hope that our article: Herpes on the eye photo, treatment and symptoms was useful to you!