Herpes of the Eye - Treatment

What was the treatment for your herpes zoster ophthalmicus?

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How are herpes eye infections treated?

Initial treatment is with either topical (drop) or oral antiviral medication. In certain less common cases, intravenous medication is also necessary.

The antiviral drugs currently available suppress the reproduction of the virus, thus reducing the number of active viruses. This may shorten the duration and severity of the infection and possibly reduce the odds of a recurrence.

Unfortunately, there is still no antiviral medication that cures one of herpes. When we acquire herpes viruses, they incorporate themselves into the cells in our nervous system where they remain inactive and quiet (latent) for months or years. No treatment has been developed to date that can eradicate the viruses when in their latent state.

When the virus becomes active for whatever reason, it begins reproducing and its progeny viruses travel from the spinal cord along the nerves and on to the end of the nerve where the infection occurs (at the skin or cornea). The antiviral medications available today only affect these actively replicating viruses, not the latent viruses in the nervous system.

In addition to antiviral medications, antibiotic drops or ointment might be used preventatively to reduce chances of a bacterial infection developing in the area of viral infection. This is because when the cornea is eroded, it becomes more vulnerable to a bacterial infection.

If the eye pressure (intraocular pressure) rises due to internal swelling (inflammation) of the eye or direct herpes virus infection of the trabecular meshwork (the internal drainage channels within the eye), a pressure-lowering medication will also be necessary.

Inflammation of any of the tissues of the eye may be so significant as to require anti-inflammatory medications such as steroids. While steroids can control inflammation very well, they can also compromise the immune system, so most often they are carefully introduced once the active viruses are well controlled by antiviral medication. In some cases, the inflammation is chronic or recurring, requiring several rounds of steroid treatment.

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