What are treatment options for herpes eye infections?
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 work by suppressing 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. The herpes viruses are incorporated 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 in their latent state.
When the virus becomes "active" for whatever reason, it begins reproducing and its progeny virus travel along a nerve to the site of the infection (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 secondary bacterial infection.
The eye pressure (intraocular pressure) can rise as a result of internal swelling (inflammation) of the eye or direct herpes virus infection of the trabecular meshwork (the internal drainage channels within the eye). If so, a pressure-lowering medication will also be prescribed.
Herpes affecting the middle layer of the cornea (herpetic stromal keratitis), back layer of the cornea (herpetic endotheliitis), and iris (herpetic iritis) are associated with significant inflammation. Inflammation of any of the tissues of the eye may require anti-inflammatory medications such as steroids. In some cases, the inflammation is chronic or recurring, requiring several rounds of steroid treatment.