Herpes of the Eye (cont.)

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What are the possible risks and complications of untreated herpes eye infections?

In the worst case scenario, untreated herpes eye infections lead to blindness, chronic pain, and loss of the eye. Aggressive treatment is aimed at reducing the chances of scarring, eye pressure problems, and direct damage to the eye tissues.

What is the prognosis of herpes eye infections?

Thankfully, the majority of HSV eye infections is limited to the cornea and resolve within a couple of weeks with antiviral therapy, leaving little or no permanent damage.

With HZV and shingles, the keratitis may resolve over a similar time frame. However, it is not uncommon for a painful burning sensation to linger in the area of the skin rash for months or even years. This is referred to as "post herpetic neuralgia" and sometimes responds to neurologic medications aimed at suppressing the pain nerves.

Both types of herpes eye infections can leave a residual corneal scar that can blur the vision. In some cases, this can be corrected with surgery. Damage to the corneal nerves can also lead to chronic, mild-to-moderate numbness of the cornea, causing dry eye and, in advanced cases, predisposing to dry-eye related corneal erosions or ulcers. In these cases lubricating drops, punctal plugs, and sometimes eyelid surgery may help protect the cornea.

Unfortunately, both HSV and HZV ophthalmicus can recur with unpredictable frequency in either eye. Frequent recurrences should warrant a general medical checkup to rule out any underlying condition that may be weakening the immune system. However, in many cases it is the virulence of the particular virus strain that determines its activity level.

Medically Reviewed by a Doctor on 5/19/2014

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