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The symptoms of an ocular herpes infection can be quite variable depending on the severity, and this can make it hard to diagnose. There is usually a fever blister on the outer part of the eye, but it won’t be visible to an untrained individual. Often, the only visible sign may be a redness in the eye which can be very severe.
Some people experience severe pain in the eye, while others only feel some mild irritation. The infected eye will typically water and run constantly, and it’s also relatively common for people to have blurred vision. The eye infection may be accompanied by cold sores in the mouth or on other parts of the face, and it's common for only one eye to get infected.
In rare instances, the infection may affect deeper parts of the person’s eye, and these cases have a greater chance to cause permanent vision damage. When the infection is deeper, the symptoms are generally similar, but they may be more severe.
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There are many strains of herpes, but they can be broken up into two basic types. The first type is the well known sexually transmitted disease that mostly affects the genitals. The second type usually causes cold sores in the mouth. Ocular herpes infection comes from the second kind of virus, which is generally much more common than the first.
In a typical case, a person will develop cold sores from the herpes virus and then the disorder will go dormant for a while. This dormant period could last for years, and while the virus is dormant, it will rest in the person’s facial nerves. Eventually, the virus can reawaken and follow the pathway of the nerves until it finds its way into an individual’s eye. At this point it will usually infect the outer part of the eye, but for some people it may infect the retina or other deeper areas.
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The most common treatment for infection with ocular herpes is antiviral eye drops. These don’t cure the virus but they can make it go dormant more quickly, which can protect the eye from undue damage. Sometimes doctors may also use steroid eye drops to lessen symptoms, and this is especially common for people who have infections in deeper eye layers. Another common therapy is to use contact lenses to help deliver medications and protect the blistered part of the eye from damage.
When none of these treatment approaches work, people may suffer permanent vision damage, which could require a corneal transplant procedure. This is not normally necessary, but it's known to work very well when it is required.
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Digital Journal of Ophthalmology. Herpes Simplex Virus in the Eye
University of Illinois at Chicago Department of Ophthalmology. Ocular Herpes Simplex