How to cure herpes before your eyes forever. The danger of herpes appearing in the eyes. Common symptoms of herpes on the eyes

– damage to the eyeball or appendages of the eye caused by infection with herpes simplex virus (HSV) 1, less often type 2. Clinical manifestations include lacrimation, pain, photophobia, blepharospasm, and the appearance of a “veil” or “fog” before the eyes. Diagnosis is based on identifying HSV using fluorescent antibodies, studying the nature of damage to the organ of vision using biomicroscopy, visometry, ultrasound of the eye, and tonometry. Antiviral drugs are used as etiotropic therapy. Additionally, NSAIDs, antibacterial drugs, reparants, antioxidants, glucocorticosteroids, and immunostimulants are indicated.

General information

Ophthalmoherpes occurs with a frequency of 1:8000. 25% of patients with a primary lesion experience relapses. After repeated cases of herpes, a recurrent course is observed in 75% of cases. The ratio of the incidence of primary and recurrent forms is 1:9. This pathology most often leads to clouding of the cornea and the development of corneal blindness. The prevalence of herpetic keratitis in the general structure of inflammatory diseases of the organ of vision among adults is 20-57%. In childhood, this figure reaches 70-80%. Males and females get sick with the same frequency. The disease is widespread.

Causes of ophthalmoherpes

The development of ophthalmoherpes is caused by infection with herpes virus type 1. In rare cases, herpes eye infections are caused by HSV type 2. The role of HSV type 6 in the occurrence of ophthalmic herpes has not been fully studied. Activation of a persistent virus in the body is facilitated by stress, traumatic injuries, infection, hypothermia, and hyperinsolation. At high risk are pregnant women with a history of herpes and people who have been treated with prostaglandins, glucocorticosteroids, and immunosuppressants. Injury to the cornea leads to deep erosion of herpetic origin.

Pathogenesis

The herpes virus most often affects the cornea. The nature of the development of secondary changes is determined by the viral load and the state of the immune system. It has been proven that pathology often occurs against the background of a deficiency of cellular immunity. The likelihood of virus penetration increases with a decrease in the production of interferon and secretory antibodies by subepithelial lymphoid tissue. Pathological agents can enter the tissue of the eyeball through exogenous, hematogenous or neurogenic routes. During exogenous penetration, the virus multiplies directly in the thickness of the epithelial layer of the cornea. The long course of cytopathic and degenerative-dystrophic processes leads to necrosis and rejection of corneal tissue.

In case of superficial damage, a small defect is formed, which subsequently epithelializes. This leads to persistence of the virus in the trigeminal ganglion and the membranes of the eye. Exposure to unfavorable factors causes the activation of pathological agents. With deep damage to the stroma, a direct cytopathic effect provokes its destruction with the concomitant development of an inflammatory reaction. The role of antigenic mimicry in the attachment of cross-reacting antigens, which entail the activation of autoimmune reactions, is being studied.

Classification

In most cases, ophthalmoherpes is an acquired pathology. Isolated cases of intrauterine infection with the development of symptoms in newborns have been described. In accordance with the clinical classification accepted in ophthalmology, the following forms of herpetic lesions are distinguished:

Primary. Occurs during primary infection. Isolated eye damage is often characterized by the involvement of only superficial layers in the pathological process.
Recurrent. Its development is due to the persistence of HSV in the body. Unlike the primary form, the recurrent course leads to unilateral damage.
Front. When the herpes virus infects the anterior segment of the eyes, conjunctivitis, blepharoconjunctivitis, keratitis and corneal erosion occur. Depending on the nature of the inflammation of the cornea, vesicular, tree-like, geographical and regional variants of ophthalmoherpes are distinguished.
Rear. The pathology of the posterior part of the eyes is represented by retinochoroiditis, chorioretinitis, optic neuritis, acute retinal necrosis syndrome, uveitis, and retinopathy.

Symptoms of ophthalmoherpes

The clinical picture of ophthalmoherpes is determined by the nature of the damage to the structures of the eye. With herpetic conjunctivitis, patients note redness, swelling of the conjunctiva and eyelids. Mucous and purulent discharge is accompanied by burning and itching of the eyes. With the tree form of keratitis, patients complain of increased lacrimation, blepharospasm, and photophobia. Pericorneal injection is associated with severe pain. The decrease in visual acuity is due to the localization of the lesion in the optical zone of the cornea. When the infection spreads to the anterior part of the choroid, the symptoms described above are accompanied by hyperemia and “floaters” before the eyes. Posterior uveitis is manifested by blurred vision and distortion of the visible image.

Herpetic iridocyclitis is characterized by a chronic progressive course. Symptoms of the pathology include visual dysfunction, the appearance of “fog” or “veil” before the eyes. The clinical picture of retrobulbar neuritis is dominated by complaints of severe pain in the orbital area with irradiation to the brow ridges, frontal and temporal areas of the head. With herpetic myositis of the oculomotor muscles, patients note that the movements of the eyeballs are severely difficult and are accompanied by severe pain. In most patients, relapses occur once a month or more often, which indicates a severe course of the pathology. Patients report a connection between relapses and previous psychological stress, hypothermia, and acute respiratory infections.

Complications

Severe herpetic keratitis is complicated by clouding of the cornea (16%) with further development of the corneal form of blindness (5%). Often, keratoiridocyclitis potentiates the occurrence of secondary ophthalmic hypertension. In the stromal form of the disease with ulceration of the cornea, there is a high risk of inflammation of the membranes of the anterior part of the eyes (bacterial conjunctivitis, blepharoconjunctivitis, scleritis). In the chronic version of the pathology, a common complication is pan- or endophthalmitis. In 12% of patients, secondary cataract is diagnosed. The chance of glaucoma is 3%.

Diagnostics

The diagnosis is based on collecting an anamnesis of the disease, the results of laboratory and instrumental research methods. The herpes virus can be detected by using the fluorescent antibody method. The material for diagnosis is a biopsy of the orbital conjunctiva. The complex of ophthalmological examination includes:

Biomicroscopy of the eye. With dendritic keratitis, small bubble-like defects are visualized, which, after opening, lead to the formation of erosion. The edges of the affected area are raised and swollen. With a progressive course, the formation of perilimbal infiltrates is noted, which are pathognomonic for the geographical variant.
Non-contact tonometry. In the posterior form of the pathology, a persistent increase in IOP is observed, caused by the production of serous or serous-fibrinous exudate.
Ultrasound of the eye. Ultrasound examination makes it possible to identify posterior precipitates, signs of damage to the posterior parts of the uveal tract due to clouding of the optical media.
Gonioscopy. Allows you to visualize anterior synechiae and determine the presence of exudate in the anterior chamber in anterior uveitis of herpetic origin.
Visometry. Visual dysfunction is observed only when the defects extend to the optical center of the cornea.
Ophthalmoscopy. When examining the fundus, secondary changes in the retina and optic nerve head are detected in the form of swelling and local foci of hemorrhage.

Before prescribing immunotherapy, an immunological study is indicated to determine T- and B-lymphocytes in peripheral blood. Differential diagnosis of the posterior form is carried out with anterior ischemic neuropathy, central serous retinopathy. The herpetic genesis of the pathology can be suspected in the case of recurrent herpes of another localization in the anamnesis, preceding the visual symptoms of viral diseases of the respiratory tract.

Treatment of ophthalmoherpes

The main therapeutic measures are carried out by an ophthalmologist, aimed at suppressing the replication of virions and increasing the overall resistance of the body. Timely treatment begins to avoid the development of irreversible changes in the membranes of the eyeball. In the treatment of ophthalmoherpes the following is used:

Chemotherapy antiviral agents. For the superficial or stromal form of the disease with ulceration, local use of an eye ointment containing acyclovir and instillation of concentrated interferon are indicated.
Immunotherapy. Immunostimulants are used for chronic herpes infection, frequent relapses, and concomitant chronic diseases. Patients are advised to use a synthetic agent based on glucosaminil muralgyl dipeptide.
Dexpanthenol. It is prescribed in the form of a gel in the superficial form for the purpose of regenerating the cornea. Sometimes instillations of reparatives are recommended - taurine, sulfated glycosaminoglycans.
Antioxidants. Used to potentiate the therapeutic effect of reparants. Instillations of methylethylpyridinol 3 times a day are indicated.
Antibacterial therapy. Antibiotics are prescribed for necrotizing ophthalmic herpes and signs of bacterial complications.
Glucocorticosteroids. They are used upon completion of epithelization of the cornea or in the subacute stage, subject to active epithelization of the membrane. Pharmaceuticals are used topically or administered parabulbarly. Contraindicated in the acute phase of the inflammatory process if there are signs of ulceration of the cornea.
Antihypertensive drugs. This group of drugs is indicated for increased intraocular pressure or objective signs of swelling of the membranes of the eye.

In case of prolonged or complicated course of the pathology, in addition to the main treatment, non-steroidal anti-inflammatory drugs, desensitizing drugs, vitamins, and antiseptics are used. The need for their use is associated with the participation in the pathological process of not only infectious, but also allergic and autoimmune components. To increase the effect of antiviral therapy, drugs are administered using physiotherapeutic techniques - magnetic and phonophoresis. During the period of clinical remission, surgical correction of secondary complications is indicated.

Prognosis and prevention

The outcome of the disease is determined by the characteristics of eye damage. In severe cases, there is a high risk of irreversible vision loss. Timely treatment allows you to achieve complete remission. In order to prevent relapses during the period of “imaginary well-being,” it is recommended to administer a herpes polyvaccine under the control of immunological parameters. Nonspecific preventive measures are based on the treatment of herpes of other localizations, preventing contact with patients with herpes infection, increasing the general reactivity and resistance of the body.

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 therapy with systemic antiviral drugs is needed (website).

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!

Sources:

1. National Library of Medicine (USA),
2. The National Center for Biotechnology Information (USA),
3. “Ophthalmology: a textbook for universities” (Egorova E.A.),
4. “Herpetic keratitis” (Kopaeva V.G.)
5. “Modern aspects of the treatment of herpes viral keratitis” (Kasparov A.).

Herpes of the eye (ophthalmoherpes) is an infectious disease caused by the herpes virus.

Depending on the place of occurrence, it is divided into types:

herpetic conjunctivitis;
eyelid dermatitis caused by herpesvirus;
herpetic stromal keratitis;
herpetic dendritic keratitis and its variants;
postherpetic trophic keratitis.

Herpetic neuritis, iridocyclitis, episcleritis, chorioretinitis and recurrent erosions are also possible.

The occurrence of ophthalmoherpes in the eye is associated with infection. The virus is found in the patient’s saliva and in the fluid that fills the herpetic vesicles.

You can become infected through airborne droplets or contact. Most often, the herpevirus gets into the eyes with unwashed hands. For example, if you touch the area of skin or lips affected by herpes with your hands, and then rub your eyes.

Another option is from a person who has damage to the oral mucosa. In this case, the virus gets into the eyes as a result of failure to comply with basic hygiene rules - you wiped your face with an ordinary towel that the patient (including you) had previously used.

Repeated herpes on the eye usually occurs in people with suppressed immunity. Relapse occurs because the herpesvirus, even with clinical recovery, remains in an inactive state for a very long time inside the nerve ganglia and trunks.

When immunity decreases, the virus can unexpectedly become active, causing recurrent disease. Other infections, such as influenza and pneumonia, also contribute to the development of the disease; as well as hypothermia, overheating, mental or physical injuries.

Types of herpes that affect the organs of vision

Medicine knows many types of herpeviruses, but only 3 of them affect the organs of vision:

herpes simplex;
cytomegalovirus;
the virus that causes shingles and chickenpox.

Ocular herpes: symptoms

The main complaints voiced by patients are:

Pain in the eyes;
discomfort in the form of a sensation "sand in the eyes";
sensitivity to light in the affected eye;
blurred vision.

The diagnosis of ophthalmoherpes is made by a doctor based on symptoms and an ophthalmological examination.

During the examination, the specialist sees:

tiny erosions on the cornea, since the virus most often affects this area of the eye;
areas of clouding on the cornea;
hemorrhages in the sclera of the eyes;
redness of the eyes;
swelling of the eyelids

Characteristic rashes (herpetic blisters) on the eyelid, skin of the nose and forehead are possible. The herpes virus can infect one eye or both. In addition to the cornea, the retina, iris, and conjunctiva of the eye may also be affected. To determine viral damage to the deep layers of the eye, a visual examination is no longer enough, so the specialist informs the patient about the need for a special examination.

Treatment of ophthalmoherpes

If the herpes virus appears in the area of the organs of vision, do not self-medicate under any circumstances!

Herpes can affect the eye not only superficially, but also penetrate into its deeper layers. Symptoms will only indicate that you have an illness, and the extent of the damage can only be assessed with the help of special ophthalmological equipment that an eye doctor has.

And medications should only be prescribed by a specialist. We simply inform you about the seriousness of the problem, the severity of the consequences of incorrect or untimely treatment, and also so that you can be a little oriented in the variety of antiherpetic drugs.

First of all, treatment is carried out with antiviral agents: tablets, eye drops, eye ointments, as well as suppositories for young children. The sooner you pay attention to the symptoms of the disease and start antiviral therapy, the less likely you are to develop complications.

A severe stage of the disease requires more serious treatment using drugs from a different group:

agents that lower intraocular pressure;
steroidal anti-inflammatory drugs;
antibacterial agents if the herpes virus has affected the cornea of the eye.

Antiviral drugs for topical use

Products for local use are prescribed depending on which part of the eye is damaged by the virus.

If the eyelids and skin around the eyes are damaged, you can resort to 5% Acyclovir ointment or cream, or cream "Fenistil-pentsivir". Before use, carefully read the instructions: the data is applied only to the skin of the eyelids. If there is a risk of the product getting on the cornea or conjunctiva, then it is better to use 3% Acyclovir.

Along with eliminating the external manifestations of the herpevirus on the eyelids and area around the eyes by applying cream or ointment, it is also necessary to prevent the spread of infection to the cornea and retina. Antiviral drops are good for this. "Ophthalmoferon" containing interferon alpha-2a. If the cornea (and possibly other parts of the eye) is affected, the doctor will prescribe antibiotics to prevent a bacterial infection.

Treatment of a young child

For the treatment of ophthalmoherpes in a newborn child, as well as in young children, it is best to use a combination of drugs:

drops "Ophthalmoferon";
eye ointment "Acyclovir" 3%;
Viferon candles.

Antiviral drugs in tablets

Deterioration of vision and blindness are unacceptable, you must agree. We advise you not to skimp on quality drugs. If the ophthalmologist considers it necessary to prescribe you an expensive drug based on Valaciclovir or Famciclovir, then you should not argue with him. High-quality and timely treatment will allow you to prevent complications such as scars on the cornea, damage to the retina, increased intraocular pressure, deterioration and complete loss of vision.

Acyclovir-based tablets have low tropism for the virus. In other words, the drug does not find and destroy the virus in tissues well. Products containing Valaciclovir perform this function better: "Valtrex", "Valvir", "Valavir". However, the big disadvantage of these medications is the fact that if the strain of the herpes virus is insensitive to Acyclovir, then it will not be susceptible to these drugs.

What cannot be said about tablets containing Famciclovir: "Famciclovir-TEVA", "Famvir" and "Minaker". Today these are the most effective antiviral medications for herpes, although very expensive.

Intravenous forms of antiviral drugs

For severe manifestations of ophthalmoherpes, intravenous forms of antiherpetic medications based on Acyclovir and Valacyclovir are used. The dosage of drugs for intravenous administration depends on the age and body weight of the patient.

Why does herpes occur near the eye? The causes of this disease will be discussed below. We will also present the symptoms of ophthalmoherpes and medications that treat this disease.

general information

Herpes (this pathology occurs rarely on the eyelid) is a viral disease. It is characterized by a rash of blisters (grouped) on the mucous membranes and skin.

The name of the term in question is of Greek origin. Translated into Russian, it means “creeping” or “rapidly spreading skin disease.”

Description of the disease

The herpes virus does not appear in the eyes as often as, for example, on the lips, in the nasal mucosa or on the genitals. At the same time, this disease is very difficult.

In addition to the listed parts of the body, the herpes virus can infect the central nervous system, which will cause the development of meningitis and encephalitis. Internal organs are also susceptible to this disease.

Types of viruses

Herpes that appears under the eye belongs to the first type. Also, the herpes simplex virus can affect the lips, nose and other skin areas.

In the second type of this disease, the genital areas are affected.

There are also varicella zoster virus (3 types). appears on the human body. As for such a childhood disease as chickenpox, it is observed throughout the body.

Epstein-Barr virus belongs to the fourth type. It causes an infectious disease such as mononucleosis.

Cytomegalovirus is a type 5 disease.

Causes

Why does herpes occur on the eye (treatment of this disease will be presented below)? There is a lot of debate on this matter. It is not possible to name any one reason for the occurrence of such unpleasant rashes. This is because herpes can occur due to a number of different factors.

Experts say that the virus in question is present in the body of all people. Moreover, for the time being, the human immune system resists this disease. A virus that gets onto the mucous membrane of the eye spreads very rarely. This is due to the fact that the visual organs are capable of independently producing interferon, that is, proteins secreted by tissue cells in response to the invasion of harmful bacteria.

It should also be noted that the tissues of the eye are protected by so-called immunoglobulins, which are contained in the tear fluid. Herpes on the eyes, the symptoms of which will be described below, may not appear for a long time and “sleep” in the nerve ganglia.

If for one reason or another the human immune system is noticeably weakened, then the herpes virus begins to actively strengthen and manifest itself in the form of ophthalmic herpes.

Thus, we can safely note that the main and main reason for the development of the disease in question is reduced immunity. In connection with the above, the question arises: why does the human immune system fail so much? Doctors say that a decrease in the body’s defenses occurs in response to the following situations:

If one of these factors contributes to a decrease in immunity, then the herpes virus, which has been “dormant” until this moment, “wakes up” and then appears on the surface of the skin or mucous membrane in the form of grouped blisters.

It should be especially noted that this variant of the development of the disease is called endogenous. There is also an exogenous route. It is characterized by infection directly through herpetic vesicles. As you know, they contain a liquid that contains viruses in high concentrations. Once on the skin or mucous membrane of the eyes, immediate infection occurs.

This path is especially typical for young children who are constantly in contact with each other.

Signs of illness

How does herpes manifest itself in the eyes? The symptoms of this disease are quite difficult to miss. Although in some cases it is confused with an allergy or a disease that is of bacterial origin (for example, conjunctivitis, blepharitis or bacterial keratitis).

It should be noted that all of the listed pathological conditions, however, like ophthalmoherpes, are accompanied by the following symptoms:

redness of the eyelid and eye;
photophobia;
soreness;
impaired visual acuity and distortion;
lacrimation.

It should also be said that local symptoms of a viral disease can be supplemented by general ones, including headache, swollen lymph nodes, nausea and elevated body temperature.

Specific symptoms

So how to identify herpes on the eye, which should only be treated by an experienced doctor? This disease also has specific symptoms. These include the following:

unbearable itching and burning of the skin on the eyelids, as well as around the eyes;
the presence of fluid-filled blisters that burst and ulcerate.

Forms of ophthalmoherpes

The disease in question is distinguished by a huge number of manifestations. However, symptoms during relapses can vary quite significantly.

Experts distinguish the following forms of ocular herpes (depending on the damage to the tissues of the visual organs):

With this disease, the conjunctiva is affected, that is, a thin film of epithelium that covers the inside of the eyelids and the eyeball. As a rule, this lesion is accompanied by redness of the entire eye.
Keratitis. This is a disease characterized by damage to the cornea, on which viral vesicles appear.
Blepharo-conjunctivitis. Unlike herpetic conjunctivitis, an inflammatory process is added to the damage to the conjunctiva, as well as the formation of blisters on the eyelids and along the eyelash line. Rashes can even appear on the inner surface of the eyelids. Usually this causes severe lacrimation, as well as sharp pain in the eye.
Keratoiridocyclitis is an inflammation of the cornea, which is accompanied by damage to blood vessels in the visual organ. This form of the disease is the most severe. It is very difficult to cure. In this case, keratoiridocyclitis repeats again and again.

Diagnosis of the disease

How to cure herpes on the eye? Treatment for this disease should be prescribed by an ophthalmologist. However, the disease must first be correctly diagnosed. This is due to the fact that the symptoms of this pathological condition are very often confused with signs of other abnormalities.

To diagnose ocular herpes, the patient must consult an ophthalmologist. The doctor is required to examine the patient using a slit lamp. This study allows us to identify ulcerations and other lesions of the cornea, as well as inflammatory processes in the eye vessels.

Also, in stationary conditions, cells are scraped from the affected skin or mucous membrane. It will be further studied through

Another way to diagnose the disease in question is to detect whether a person has antibodies to the virus.

All of the above diagnostic methods are used only for damage to the blood vessels and cornea of the eye. As for herpetic lesions of the mucous membrane of the visual organs and the skin of the eyelids, it is noticeable even without examination.

Herpes on the eyelids is characterized by rashes (usually multiple) in the form of small blisters filled with lymph, that is, liquid that becomes cloudy over time. These blisters are very painful and itchy. Scratching the rashes will spread them further.

Ophthalmoherpes: treatment

How should ocular herpes be treated? According to experts, the type of treatment for such a disease depends on its form. If the virus has affected only superficial tissues, then medications are used that relieve discomfort in the visual organs, as well as suppress the activity of herpes.

There are 4 types of medications on the pharmaceutical market that are used for the complex treatment of ophthalmoherpes. These include the following:

immunomodulatory agents;
antiviral (for example, Zovirax ointment);
specific immunotherapy drugs (for example, herpes vaccine);
symptomatic medications, including decongestants, painkillers, vitamins, etc.

If the virus affects the deeper tissues of the eye, the patient undergoes surgery. Types of operations such as coagulation, keratoplasty and others allow you to localize or remove the affected areas.

Antiviral agents

How to eliminate herpes on the eye? Treatment of this disease is most often carried out. For this, special forms of drugs are used that are not capable of irritating the mucous membrane of the visual organs.

To suppress the excessive activity of the herpes virus, doctors recommend using eye drops and ointments. Also, for systemic exposure, patients are often prescribed antiviral injections and tablets.

What medications are most effective in treating ophthalmoherpes? Experts highlight the following drugs:

"Acyclovir". For eye damage, the medication in question is used in the form of oral tablets, as well as a local ointment.
"Valacyclovir." For the treatment of ocular herpes, this drug is used in tablet form.
Zovirax is an antiviral eye ointment that is very effective against herpes simplex viruses. After its use, the active substance of the drug is immediately absorbed by the periocular tissues and the corneal epithelium. As a result, such a concentration of the drug is formed in the intraocular fluid that is necessary for active suppression of the virus.
“Oftan-IDU”, “Idoxuridine” - these drugs are specifically designed for the treatment of ophthalmoherpes. They are produced in the form of drops that contain an analogue of thymine. The medication in question prevents the virus from multiplying and also suppresses its activity. For best effectiveness, drops must be instilled every hour. However, with prolonged use they can cause damage to the cornea.
"Trifluorothymidine" is a drop similar to "Oftan-IDU". However, it should be noted that they have a less toxic effect.
"Riodoxol", "Tebrofen", "Bonafton" - all of these drugs are in the form of an ointment. They can be applied to the skin of the eyelids, and also placed inside the eye.
"Vidarabine" is an effective gel against ophthalmoherpes. It is applied to the conjunctiva 5 times a day.

Eye drops "Ophthalmoferon": instructions

Which antiviral drug is most effective for ocular herpes? Experts say that these are Ophthalmoferon drops. Their price is about 300 rubles, so almost anyone can purchase such a product.

The medication in question contains diphenhydramine and interferon alpha-2a. It is produced in polymer dropper bottles, which are placed in cardboard packs.

Antiviral drops for lacrimation "Ophthalmoferon" have a wide spectrum of action. In addition to anti-inflammatory properties, this drug exhibits immunomodulatory, antimicrobial, local anesthetic and regenerating effects.

For what indications is the medication in question prescribed to patients? According to the instructions, it is used for:

adenoviral, ;
hemorrhagic, adenoviral and herpetic conjunctivitis;
hepertic stromal keratitis without ulceration and with ulceration of the cornea;
herpetic uveitis;
herpetic and adenoviral keratoconjunctivitis;
herpetic keratouveitis (without and with ulceration).

As for contraindications, this product has virtually none. These drops cannot be used only if you are individually intolerant to their components.

How should the drug "Ophthalmoferon" be used? The dosage of this topical medication should be determined by an ophthalmologist. In the acute stage, it is instilled into the affected eye, 1-2 drops up to 7-8 times a day. As soon as the inflammatory process begins to stop, the number of instillations is reduced to 2-3 times a day.

The course of treatment with this drug is determined by the doctor. As a rule, the use of the medicine is continued until the symptoms of the disease disappear completely.

Prevention of ocular herpes

The main set of preventive actions for ophthalmoherpes should be aimed at interrupting the transmission routes of the virus. Thus, a person needs to avoid close contact with the patient, not use the same dishes, towels and cosmetics with him, and also carefully observe the rules of personal hygiene in the presence of other forms of herpes.

As for pregnant women infected with genital herpes, they are prescribed special treatment, and then undergo intensive treatment of the birth canal in order to avoid infecting the baby as it passes through it.

If herpes occurs too often, then vaccination is carried out using a special anti-herpetic solution. It is also administered to the patient under close medical supervision.

To prevent the possible development of the virus, potential patients should definitely adjust their diet. In addition, during cold season they need to take multivitamins. The patient is also indicated for physical exercise and hardening procedures, which will improve immunity and therefore prevent the appearance of rashes.

The herpes virus can affect various organs and systems, including the organs of the visual apparatus. Ocular herpes (ophthalmoherpes) is a dangerous disease that affects the cornea. The process leads to vision impairment.

In people with weakened immune systems, the disease can recur up to five times in one year. In severe cases, the virus affects deeper tissues and provokes the development of diseases leading to blindness.

Herpetic infection causes inflammation of the cornea - keratitis, which is the main cause of deterioration in visual function. Before we talk about treatment, let's look at the common causes of eye herpes.

Provoking factors

Depending on the time of occurrence, herpes can be congenital or acquired. Herpes over the eye can be caused by the following pathogens:

herpes simplex;
chickenpox virus;
genital herpes;
cytomegalovirus.

In a healthy person with a strong immune system, the eyes are well protected from pathogenic microflora. Tears contain immunoglobulins, which prevent the spread of viral infection.

Herpes on the eye is a highly contagious disease, meaning it is very easy to become infected with herpes viruses. Let us highlight the main routes of transmission of infection:

airborne;
contact;
sexual;
domestic;
transplacental;
ascending.

Primary infection usually occurs through contact with an infected person or through the use of shared objects.

Let's consider the provoking factors leading to the appearance of herpes near the eye:

stressful situations:
hypothermia;
weakened immune system;
infectious diseases;
eye injury;
pregnancy;
taking cytostatics or immunosuppressants;
prolonged stay in conditions of abnormally low or, conversely, high temperatures;
long-term antibacterial therapy;
monotonous food.

Symptoms

Let us highlight the characteristic signs of herpes on the eyelid:

profuse lacrimation;
redness of the eyeball;
blurred vision;
narrowing of the palpebral fissure;
itching, tingling;
photophobia;
eyelid twitching;
weakness, headaches;
low-grade fever up to 37.5 degrees;
lump-like thickening of the skin;
pain, foreign body sensation;
the appearance of bubbles with dirty yellow discharge. After they burst, crusts appear.

Crusts form in place of burst bubbles

In case of damage to the retina by the herpetic virus, more serious symptoms appear, namely:

closing the eyes in the form of convulsions;
diplopia – double vision;
distortion of objects;
the appearance of flashes before the eyes;
blurred vision.

Clinical forms of herpes

Let's consider the forms of herpes and their clinical characteristics.

Herpetic dermatitis of the eyelids

The disease occurs in the form of herpes simplex or herpes zoster. It has an acute onset. The main symptoms of the disease are as follows:

redness of the eyelid;
bubbles with clear liquid, in place of which crusts appear over time;
burning and itching;
chills;
headache;
elevated temperature.

Bubbles can be either single or multiple. Herpetic dermatitis of the eyelids has a tendency to recur.

In shingles, the trigeminal nerve is affected. This causes severe neurological pain along the trigeminal nerve, in the orbit, dizziness, headache, and the appearance of a blind spot in the field of vision. Patients complain of severe pain when moving the eyeball. After the wounds heal, scars appear.

Ringworm on the eye causes redness of the eyelids

For simple lichen, wet areas are lubricated with a solution of brilliant green. The crusts are lubricated with antibiotic ointments. Multivitamin complexes are prescribed for oral use.

To combat shingles, the rash is lubricated with oxolinic ointment, Zovirax or Bonafton. To achieve an analgesic and anti-inflammatory effect, Analgin or Reopirin is prescribed. Before applying the ointment and instilling drops, hands are thoroughly washed with soap and disinfected with a special gel.

Herpetic conjunctivitis

Herpetic conjunctivitis is characterized by unilateral lesions. Inflammation of the mucous membrane of the eye manifests itself as follows:

mucous discharge from the eyes;
sticking of eyelids;
sensation of a foreign body in the eye;
lacrimation;
dryness and burning;
photophobia;
swelling and redness of the eyelids and skin around the eye;
red eyeballs;
blisters on the cornea, skin and eyelids.

The photo clearly shows herpetic conjunctivitis with swelling

Treatment of eye herpes includes the use of antiviral, antibacterial and glucocorticosteroid drops. Lack of timely treatment threatens vision deterioration, infection and scarring.

Herpetic keratitis

With keratitis, a herpetic infection affects the cornea. The disease is prone to recurrence and threatens complete loss of vision. The initial period of herpetic lesions resembles a mild bacterial infection in its manifestations. It is characterized by the appearance of the following symptoms:

lacrimation;
redness;
increased sensitivity;
photophobia;
corneal edema;
small blisters turning into ulcers;
blurred vision.

The disease cannot be treated with antibiotics and is often progressive. In some cases, the disease goes away without treatment. After several recurrent cases, ulcers form, clouding of the cornea occurs, and its sensitivity is also impaired.

Antiviral ointments and drops are used to treat keratitis. In severe cases, hospital treatment under the supervision of an ophthalmologist is indicated. Patients are treated with antiherpetic and immunomodulatory drugs.

Reddened skin around the eyes is lubricated with antiviral ointments

Stromal keratitis

The disease is characterized by damage to the deeper layers of the cornea, which can lead to complete blindness. Manifestations of stromal keratitis can be quite different:

irritation and pain in the eye;
blurred vision;
swelling;
lacrimation;
redness;
sensation of the presence of a foreign body;
ulcers on the cornea;
photophobia;
mucous discharge.

If the surface layers of the cornea are affected, ointments, drops and tablets with an antiviral effect are prescribed. If conservative treatment is ineffective, surgery may be necessary.

The upper eyelid with herpes is red and swollen

Herpes on the eyelid of a child

Most children are born with antibodies that protect them from herpes infection, but these disappear within six months. Parents should pay attention to the fact that after vaccination, the child’s immune system is reconstructed and may not have time to respond to an attack by harmful microorganisms, including herpes viruses.

The first symptoms of the disease that you should pay attention to are:

redness and irritability of the eyes;
blisters on the eyelids;
itching and burning;
lacrimation;
photophobia;
foreign body sensation;
acute pain in the eye;
inability to open the eye.

How to treat?

Herpes under the eye is treated depending on the form and severity of the disease. Therapeutic tactics include combating the infectious agent and unpleasant clinical symptoms.

Drug treatment includes the use of the following drugs:

Valaciclovir for oral administration;
Oftan-IDU antiviral drops are dripped one six times a day;
Miramistin antiseptic drops are instilled into the conjunctival sac, one six times a day;
Naklof anti-inflammatory drops are dripped three times a day;
For allergic reactions, use antihistamine drops Opatanol.

Anti-herpetic vaccination will help prevent relapse

Antiviral ointments will help relieve the symptoms of herpes:

Acyclovir is applied to the affected areas four times a day;
Tebrofen ointment is applied to the edges of the eyelid three to four times a day for two weeks;
Vidarabine is applied every three hours.

Traditional medicine is used as an auxiliary therapy. The following recipes are used to wash the eyes:

take dry leaves and marshmallow leaves. Two tablespoons of raw materials are poured into a glass of boiling water. The product is infused for half an hour, filtered, and then used for the procedure;
pour a teaspoon of lungwort with 250 ml of boiling water. The product should be infused for two hours;
Several rose hips, two lungwort leaves, and a teaspoon of bird cherry leaves are infused in a glass of boiling water.

Important! It is forbidden to wash both eyes with the same cotton pad.

Compresses will help relieve inflammation and speed up the healing process:

You will need arnica flowers and leaves. A tablespoon of raw material is poured into a glass of boiling water and left for two hours;
combine freshly squeezed aloe juice with water at a ratio of 1:10;
a spoonful of dry celandine is poured with 250 ml of boiling water. After the solution has cooled, add a little honey to it;
Mix fresh dill with water.

Following the rules of personal hygiene will help reduce the likelihood of relapse. Avoid contact with carriers of infection

do not give personal hygiene items to anyone: towel, washcloth, soap;
Change your bed linen regularly. If you are already sick, wash your bedding using high temperatures;
avoid exposure to strong winds;
the room in your home should be sufficiently humidified;
Don’t strain your eyes, don’t forget about rest.

Summary

Herpes on the eye is a dangerous disease that should be treated by a qualified specialist. Maintaining personal hygiene will help speed up the healing process and reduce the likelihood of relapse. The basis of treatment is antiviral ointments and drops. Antibacterial agents are also used to prevent bacterial infection. Traditional recipes are used as a supplement. Do not forget that the first stage of treatment is diagnosis, so when the first symptoms of herpes appear, contact a specialist.