Ocular herpes: photos, early symptoms, contagious?

We call ocular or ophthalmic herpes a herpes that develops in the mucous membrane of the eye. Among the causes: herpes simplex virus (HSV) infection Or Varicella zoster virus (VZV) infection. Ocular herpes affects about 60,000 people a year in France and is the leading cause of blindness of infectious origin in industrialized countries, according to the National Union of Ophthalmologists of France (SNOF). How to recognize ocular herpes? What are the early symptoms? Tiredness ? Headaches ? How to treat it? Is ocular herpes contagious?

What is the definition of ocular or ophthalmic herpes?

Ocular herpes, also called ophthalmic herpes, is a herpes that develops in the mucous membrane of the eye. It is a disease transmitted by the Herpes simplex virus (HSV) or by the Varicella zona virus (VZV).

Photo of an ocular herpes

Is ocular herpes contagious?

Yes. This ailment contagious is transmitted by simple contact with a subject carrying the virus or by self-contamination. In the latter case, the person rubs their eyes after coming into contact with other herpetic areas of their face (commonly called “cold sores”).

What are the symptoms of the onset of ocular herpes?

At the beginning, we can confuse herpes of the eye with conjunctivitis acute:

• The eye has a reddish appearance
• The eye is watery
• The eyelid is swollen
• The patient feels a sensation of “grains of sand in the eye”.

“Nevertheless, with a little practice, the localization of the redness around the cornea (while it is diffuse in the case of conjunctivitis) already directs towards serious eye damage“, emphasizes Professor Laurent Kodjikian, President of the French Society of Ophthalmology and Deputy Head of Department at the Croix-Rousse Hospital in Lyon. Once the pathology has been diagnosed, there may be recurrence; with each episode, the disease can get worse and can damage the cornea, gradually causing it to become cloudy. Frequent attacks of this virus cause nerve damage which reduces the sensitivity of the eye.

When to consult a doctor ?

• When small clustered blisters are present in the eye area and on the eyelid
• If a cold sore occurs

From the first symptoms – red and watery eye, and swollen eyelids – you should consult an ophthalmologist who can diagnose the lesions. Because the virus will then attack the cornea, the transparent membrane that covers the eye, and cause keratitis. “At this stage, visual acuity drops and it becomes an ophthalmological emergency: if nothing is done, in less than a week, the cornea can be completely destroyed”, adds the doctor.

What are the causes of ocular herpes?

► Firstly: lhe virus called HSV-1 (Herpes Simplex Virus) is the major cause of ocular herpes. It is easily transmitted by contact with the mucous membranes or skin of an infected person. A newborn can catch herpes of the eye if his mother was infected with genital herpes at birth (HSV-2).

► The disease can also be self-transmittedwhen a subject with cold sores touches his eye after scratching his cold sore.

► Also, the herpes virus VZV (Chickenpox Zoster Virus) may also be involved.

Most often, herpes affects the eye from a cold sore (herpes labialis). It is caught by contagion during contact with a person carrying the herpes virus, or by self-contamination of the subject who rubs his eyes after touching other herpes lesions on the face. “The vesicles are very contagious because they are full of virus and the person who has a cold sore is contagious from the first signs and remains so until the lesions disappear”, warns the Professor. The virus is also present in saliva. Care must be taken not to project droplets of saliva. Contact lens wearers should not moisten their lenses with their saliva.

Only a general practitioner or an ophthalmologist is able to make a diagnosis of possible ocular herpes or one of its main complications: herpetic keratitis, using a clinical examination.

The best known treatment for ocular herpes is based onaciclovir antivirusI. It comes in the form of 3% eye ointment to be applied 5 times a day for ten days. If antiviral eye drops are not systematically used, frequent use is antiseptic eye drops and those based on atropine which exert an anti-inflammatory action and which dilate the pupil. When the intervention is too late, it is necessary to proceed to a corneal transplant which must be accompanied by an anti-rejection treatment based on cortisone.

Is there a vaccine against ocular herpes?

Currently there is no vaccine against this virus, but research is ongoing.

Thanks to Professor Laurent Kodjikian, President of the French Society of Ophthalmology and Deputy Head of Department at the Croix-Rousse Hospital in Lyon.