Herpes eye infection and blindness?

(1) Dear Alice,

This question is in reference to herpes and the eyes. Can one become blind due to herpes infection of the eyes? Also, how should one clean one's hands when one comes into contact with herpes? Soap or some other antibacterial type cleanser?

(2) Dear Alice,

Concerning herpes infections, I've read that they can occur in the eye(s). How would one tell if the infection is present in the eye(s)? Is there any treatment or cure that is available to control or eradicate the infection within the eye(s)?

Dear Readers,

It's true: the herpes virus can infect various parts of the eye, including the eyelid, cornea, and parts of the inner-eye. Thankfully, you can still safely make steamy eyes with someone across with room without worry — similar to other herpes infections, the ocular variety is transmitted through skin-to-skin contact. Although this type of infection is fairly uncommon (affecting about 50,000 Americans each year), it can have serious consequences and may result in blindness if left untreated. There is no cure for herpes, but the good news is that are a number of treatments available to manage the infection.

Most commonly, the type of herpes that infects the eyes is herpes simplex virus I (HSV-1), the same type that causes cold sores on the mouth. The herpes-zoster virus, the culprit behind the chickenpox, can also infect the eyes in folks who develop shingles later in life. If you come in contact with another person's open sores, proper handwashing (and avoiding contact with your eyes) can help prevent the spread of the virus. Reader #1, you asked about how and what type of soap might assist in the prevention of infection. For folks who don't work in a health care setting, the Centers for Disease Control and Prevention (CDC) recommend washing your hands with plain (not antibacterial) soap and water as a basic tool for curbing the spread of germs from one person to the next. For detailed tips on handwashing techniques, check out Handwashing do's and don'ts in the Go Ask Alice! archives.

Herpes in the eye may present different symptoms depending on which part of the eye is affected. For example, if the eyelid is infected, it may cause a blistering rash. However, if the virus has affected the inside of the eye or retina, it may result in decreased vision. When the herpes virus affects the cornea, symptoms may include redness, tearing, light sensitivity, headache, or feeling like you have something in your eye. If the infection in the cornea worsens and spreads deeper, scarring can occur (a condition called stromal keratitis) and result in blindness. When the herpes zoster virus (via shingles) infects the cornea, it may result in decreased sensitivity of the area. This means it may be harder to tell when foreign matter (like an eyelash or dust) is in your eye. As you can see, Reader #2, theses aren't the type of symptoms that would have you saying, "A-ha, I must have herpes in my eye!"

If you're experiencing these or similar symptoms, it's wise to speak with a health care provider sooner rather than later to determine their exact cause. While the herpes virus can't be eradicated, there are treatments available to help control the infection by reducing symptoms and the number of outbreaks. Depending on the location of the infection and the severity, treatment may include swabbing the cornea to get rid of damaged cells, use of antiviral medication, medicated eye drops, or surgery. Recurrence is unlikely for those who've suffered from an ocular herpes outbreak due to shingles and otherwise have a healthy immune system. However, for those with HSV, factors such as illness and stress can spur additional outbreaks in the future. In addition to any recommended treatment, eating well, getting plenty of sleep, and managing stress can help support a healthy immune system — and in turn, reduce the likelihood of herpes outbreaks and other illnesses.

Hope this helps you see the facts clearly!

Last updated Oct 23, 2015
Originally published Jan 21, 1999

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