Eye herpes can cause uncomfortable symptoms, including redness, light sensitivity, and the feeling of something in the eye. Some people may also develop sores on the eyelids.

When herpes simplex virus (HSV) symptoms affect the eyes, it is known as eye herpes, ocular herpes, or herpetic eye disease.

Recurrent infections can increase the risk of complications, such as corneal scarring, secondary glaucoma, and retinal detachment.

This article examines the types of herpes that can affect someone’s eye, including their symptoms, diagnosis, and treatment options.

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There are two major types of HSV:

  • Type 1: Herpes type 1 (HSV-1) can be asymptomatic or cause symptoms such as cold sores, which some people refer to as fever blisters.
  • Type 2: Herpes type 2 (HSV-2) is the sexually transmitted form of the virus. While this type mainly causes symptoms on the genitals, it can also affect the eyes.

According to the American Academy of Ophthalmology (AAO), HSV-1 is more likely than HSV-2 to cause eye infections.

A person will typically contract either form of the virus after skin-to-skin contact with someone who already has herpes. The virus may lay dormant in the nerve cells and can travel along the nerves to the eye upon activation.

The AAO estimates that 90% of people are exposed to HSV-1 in their lifetime, typically as children.

When a person gets herpetic eye disease, they can experience a variety of symptoms. These can occur in both eyes, but they may affect one eye more than the other.

Some of the symptoms depend on the affected part of the eye. Examples of these symptoms include:

Sometimes, people may also experience herpes sores on top of the eyelids. These may resemble a rash with blisters. The blisters will form crusts that usually heal within 3–7 days.

If the herpes virus affects the cornea, the inside of the eye, or the retina, a person may experience changes to their vision. Typically, eye herpes does not cause a lot of pain, even though a person’s eye may look painful.

Conditions with similar symptoms

HSV symptoms affecting the eye may be similar to those of the varicella-zoster virus, which causes chickenpox.

Reactivation of the varicella-zoster virus can cause herpes zoster, also known as shingles. This causes vesicles, small blisters, on the forehead and scalp, which can spread to the eye on the same side.

Another condition that can have similar symptoms is pinkeye, which is also known as conjunctivitis.

The herpes virus can spread via the nasal secretions or spit of a person with the infection. The likelihood may be higher when a person has a cold sore.

The virus within the secretions can then travel through the body’s nerves, which can include those in the eye.

In some cases, the virus enters the body and does not cause any problems or symptoms. Doctors describe this form of the virus as lying dormant.

Certain triggers can cause a dormant virus to start reproducing and cause eye irritation. Examples of these triggers include:

The herpes virus can be highly contagious. However, not everyone who contracts or comes into contact with the herpes virus will get eye herpes.

Ophthalmologists, or eye doctors, diagnose herpetic eye disease by taking someone’s medical history and asking about their symptoms. They may ask when the person first noticed their symptoms and if anything makes them worse or better.

The ophthalmologist will conduct a physical examination of the eye. HSV causes dendrites, a branching pattern, on the cornea, so the examination may involve a special microscope known as a slit lamp to visualize the eye’s surface and, potentially, the eyelid.

These professionals can usually diagnose eye herpes by looking at the sores. If the infection has reached the deeper layers of the eye, they will need to use special instruments to measure the eye pressure. They may also need to inspect the deeper eye layers.

Laboratory testing for HSV of the eye is uncommon.

For the most part, eye herpes affects the transparent front part of the eye. This condition is known as epithelial keratitis.

If eye herpes affects the deeper layers of the cornea, it is known as stromal keratitis. This condition is more concerning to eye doctors because it can cause scarring on the cornea, which can permanently affect a person’s vision.

Treatment of herpes keratitis depends on its severity. Doctors will usually treat a mild infection with topical and oral antiviral medication.

Eyelids

Doctors may prescribe topical ointments, such as an antiviral ointment, for a person to apply gently to their eyelids.

Outer eye layers

If the eye herpes only affects the outermost layers of the eye, a doctor may prescribe an antiviral eye drop or an oral antiviral medication, such as acyclovir (Zovirax). These help reduce the effects of the virus and could reduce the duration of symptoms.

However, some eye drops can worsen symptoms, so people should always consult an ophthalmologist.

Deeper eye layers

If the herpes virus has affected deeper layers of the eye, an eye doctor may prescribe antiviral eye drops and oral medications.

They may also prescribe steroid eye drops. These help reduce eye inflammation that could lead to increased eye pressure.

However, the AAO highlights that people must take antiviral medication alongside steroid eye drops, as steroids can increase herpes in the body.

As eye herpes can cause further infections, some doctors may recommend taking antiviral medicines regularly to reduce the risk of getting eye herpes again.

Recurrent herpetic eye infections can lead to greater eye damage, which is why doctors aim to prevent their recurrence. Other prevention tips include:

  • avoid touching the eyes
  • wash hands thoroughly
  • practice good hygiene
  • attend regular eye exams
  • use contact lenses as an eye doctor instructs

According to a 2021 review, over 1.8 million people experience herpetic eye disease every year. While there is no cure for eye herpes, treatment can reduce the duration of symptoms.

If someone has recurrent eye infections or starts to experience vision loss, they should seek an appointment with an eye specialist for an assessment and advice on additional treatments.

Below are the answers to some common questions about eye herpes.

What does eye herpes look like?

A person with herpes in the eye may experience watery eyes and redness. Some people may also have sores, which look like small blisters, on their eyelid.

How can someone tell if they have eye herpes?

The symptoms of herpes in the eye may be similar to other conditions, such as conjunctivitis and infection with the varicella-zoster virus. People should speak with a healthcare professional for an accurate diagnosis.

Does eye herpes go away?

Early diagnosis and treatment can relieve the symptoms of eye herpes and help it go away faster. The duration of the condition may depend on the person and the severity of the herpes, but symptoms may resolve within 2 weeks with treatment.

Herpes can affect the eyes, causing symptoms such as redness, irritation, and watery eyes. Some people may also have small blisters on the eyelids.

Doctors can prescribe medication, such as eye drops or antifungal medications, to help treat eye herpes and prevent complications that can affect someone’s vision.

People should take steps to prevent herpes recurrence, including washing hands regularly and avoiding touching the eye, particularly if they have a cold sore.