Organs

Ophthalmoherpes symptoms and treatment. Ocular herpes: symptoms and treatment. Outer layers of the eyes

Ophthalmoherpes is the most dangerous form of manifestation of the herpes virus in the human body. The fact is that by affecting the cornea of the eye, it can lead to rapid deterioration of vision. If you do not consult a doctor in time, it can penetrate into the deep tissues of the organ of vision, and this is fraught with loss of vision.

Near the child's eye

In general, our eyes are well protected from the effects of viral infections. The tear that is constantly released from the eye contains a sufficient amount of secretory immunoglobulins of class A, mucosal cells, which, at the slightest attack by pathogens, begin to actively produce interferon, blocking their further spread.

So in what cases does herpes develop on the mucous membrane of the eye?

First of all, infection occurs during a decrease in the level of the body’s defense – immunity.
Mechanical damage to any part of the visual organ.
Pregnancy, when a woman’s body is weakened ().
After taking immunosuppressants.
Subsequently suffered stress.
Hypothermia and colds.
During overheating in the sun.
Hormonal disorders and changes in the body.
Past vaccinations, including.

Initially, you can become infected with the herpes virus on the eye through contact with a carrier of the disease and through the use of his things, since the virus enters the body through the mucous membrane of the oral cavity or subsequently through sexual contact. There is also a chance of contracting the disease through sharing dishes, towels or personal hygiene products.

There are two routes of infection:

Endogenous. The herpes virus in the eye enters the epithelium, multiplies and quickly spreads throughout the body using the circulatory and lymphatic systems. Once in the nerve endings and nodes, it remains there for the rest of its life, dormant and waiting in the wings.
Exogenous. Herpetic blisters immediately affect the mucous membrane of the organ of vision. This route of infection is especially common in children. Newborns can “receive” the virus by passing through the birth canal of the mother, who.

It is worth mentioning that the disease is caused by two viruses. The first is the smallpox virus, which affects the eye. Another virus causes herpes under the eye, affecting the cornea.

What happens when the eyes become infected?

When the herpes virus enters the eye and its tissues, it begins to multiply rapidly, affecting the upper layer of the cornea. Having accumulated in sufficient quantities in keratocytes, the disease begins to damage the membrane. Having destroyed it, it comes out, infecting all the cells in the neighborhood. The latter, together with adjacent tissues, die and begin to peel off. Possible autoimmune infection.

Clinical symptoms.

Expressed in:

The eyeball and eyelid are too red.
Profuse lacrimation.
Sharp and sharp pain in the eyes and head.
Feeling of a foreign body and pain.
Objects are seen in a distorted form and a veil appears.

Ophthalmic herpes, the symptoms of which depend on the clinical form, is typical:

With herpetic dermatitis of the eyelids, there is redness, bubbles with liquid appear, the skin burns, and the temperature rises.
With herpetic conjunctivitis, a rash appears and the eyes turn red.
With herpetic keratitis, the level of sensitivity of the cornea decreases, there is a fear of light, excessive production of tears, and bubbles with liquid form on the nerve fibers of the cornea.
With stromal keratitis, the vascular tract is affected, the iris increases in size, intraocular pressure is increased, the eye disc is displaced.
With a herpetic corneal ulcer, there is no sharp pain.
With herpetic uveitis, the vitreous body becomes cloudy, precipitates occupy a central location, and a “blind spot” may appear.
In acute retinal necrosis, there is a possibility of losing vision as a result of inflammatory processes in the eye.
With postherpetic trophic keratitis, the cornea of the eye thickens, the sensitivity of the cornea is completely absent, and vision rapidly decreases.
With herpes in children, the conjunctiva swells and a herpes rash is visible at the edges of the eye.

Diagnostics.

When suffering from ophthalmic herpes, inflammatory processes in both adults and children have the same symptoms. This allows you to quickly identify them and begin treatment. To accurately diagnose the disease it is necessary:

Inspect the skin of the eyelids, where a herpetic rash can be detected.
Check your vision, as during a viral infection it worsens significantly.
Take a test to determine your vision limit.
Check corneal sensitivity. Often it is absent or reduced to a minimum.
Examine the anterior and posterior parts of the eyeball.
Examine the fundus to identify other infectious diseases.

These laboratory tests are required, since sometimes it is very difficult to determine the infection by eye. Along with this, it is necessary to undergo tests such as:

A scraping from the eye membrane to determine the presence of antibodies to the virus.
A general blood test to determine the level of leukocytes and lymphocytes.
A smear from the membrane of the eye and cornea. This test detects the DNA virus.

Complications of ophthalmoherpes.

Keratitis - caused by ophthalmoherpes

Of particular danger to our body are the complications that can develop after ocular herpes. There are two forms of complications:

Specific. This form of complication is caused by incorrect and neglected treatment. The viral infection, having overcome tissue barriers, enters the blood and lymph. This leads to damage to internal organs. It can often be confused with a chronic disease. Ocular herpes can lead to rapid deterioration of vision or its complete loss, clouding of the cornea and increased pressure inside the organ of vision. Often accompanied by headache.
Non-specific. It is characterized by the addition of a foreign infection of a viral or bacterial type. Promotes the development of nerve atrophy, retinal detachment, inflammation of the veins of the eye, and nerve neuritis.

Treatment and medications.

Treatment of herpes on the eye depends on the clinical form of the disease and is prescribed strictly on the recommendation of an ophthalmologist. Therapeutic treatment involves the use of measures to prevent the reproduction of the infectious virus and its further spread. It is applied until external manifestations completely disappear.

The most are:

Acyclovir.
Valacyclovir.
Cidofovir.

OFTAN-DIU has excellent antiviral properties, which eliminates infection and its manifestations. In order to relieve inflammation of the eyeball and remove rashes on the eyelid, drops such as Okoferon and Miramistin, Okomistin and Indocollir are used.

Effective results from physiotherapy. You can fight the disease with the help of medicinal electrophoresis using atropine, hydrocartisone and aloe extract. Thanks to its deep penetration, rapid healing of eye tissue occurs.

In addition to medications, you can additionally use:

Means to strengthen the immune system.
Antipyretic and painkillers.
Iodine. They apply it to the rash. It dries it well and speeds up the crust formation process.
Compresses. They do a great job with itching. Prescribed on the recommendation of a specialist. Particularly suitable for children.

Some people rely on traditional medicine. However, remember that it cannot replace the full treatment of ophthalmoherpes with medications. Its role is rather auxiliary and is aimed at reducing pain, as well as speedy healing of wounds. Before using herbal infusions, make sure that you are not allergic to some of the components.

The most common are infusions of lungwort, vitamin teas and decoctions of arnica flowers. Their dried extracts are diluted with hot water and used as lotions and compresses. Teas are accordingly taken orally.

Prevention.

Recommendations from the company Cycloferon.

To prevent the disease you need to follow some simple rules:

First of all, wash your hands thoroughly with soap and water before touching your eyes.
If you wear contact lenses, then during the infection with the herpes virus, give them up altogether.
Do not try to peel off the bubbles when a crust forms on them.
Engage in increasing the protective function of the body - immunity. Try to lead a healthy lifestyle - eat well, exercise in accordance with your age and health status, and sleep at least 9 hours a day.
Try to limit communication with people who are potential carriers of the virus.
Do not use other people's cosmetics.
Do not abuse fizzy drinks - they provoke inflammation of ophthalmoherpes with their composition.
Eat more foods that contain lysine.

Thus, ophthalmoherpes, although not a very common disease, is quite complex. After all, it affects the main and only organ of vision – the eyes. Having identified the first symptoms of the disease, you must consult with a specialist in order to prevent its complications and spread to other vital organs.

Who said that curing herpes is difficult?

Do you suffer from itching and burning in the areas of the rash?
The sight of blisters does not at all add to your self-confidence...
And it’s somehow embarrassing, especially if you suffer from genital herpes...
And for some reason, ointments and medications recommended by doctors are not effective in your case...
In addition, constant relapses have already become firmly established in your life...
And now you are ready to take advantage of any opportunity that will help you get rid of herpes!

There is an effective remedy for herpes. and find out how Elena Makarenko cured herself of genital herpes in 3 days!

Ophthalmoherpes is damage to the cornea, eyeball and adjacent areas by herpetic infection. The causative agents of the virus remain for a long time in the tear ducts after treatment and often provoke repeated outbreaks of herpes in the eyes. The disease causes vision impairment. When ophthalmic herpes occurs by gravity, deep organs are damaged, which leads to surgical intervention or disability.

Ophthalmologists have adopted the following classification of ophthalmoherpes.

By pathogenesis:

primary;
recurrent.

Clinical and anatomical:

Anterior section:
- surface forms;
- deep forms.
Posterior section.

Causes of herpes in the eyes

The main causative agents of herpetic eye infections are:

HSV type 1 (provoker of colds on the lips).
HSV type 2 (causes genital herpes).
VZV type 3 (varicella and herpes zoster virus).

Less likely to provoke pathology:

HSV type 5 (cytomegalovirus that affects internal organs: kidneys, liver, lungs, heart).
HSV type 6 (accompanies roseola infantum).

The pathogenesis of the virus is represented by the introduction of its DNA into the cells of the body, where macroparticles of the pathogen multiply. The organs of vision are equipped with a good secretory function, which provides the lacrimal canal and epithelium with antibodies. But their effect weakens due to a general decrease in immunity. Ocular herpes enters through the outer layers and affects the cornea, leaving erosions. At this point, the active phase subsides, and herpes cells enter a latent existence in the lymph nodes and dermis.

There is also a congenital pathology of viral eye disease. Recurrence of the pathology in a pregnant woman is fraught with the transmission of the HSV virus to the fetus in the prenatal period.

Factors contributing to ophthalmoherpes include:

pregnancy, taking cytotoxic drugs, antibiotics, drugs that suppress the immune system;
weakened body defense;
active form of cold herpes, when the virus can be transmitted to the eyes through saliva;
damage to the purulent vesicle due to herpes and contact of the contents with the mucous membrane of the eye;
household form of infection through a towel, ophthalmic drops, glasses;
overheating in the sun;
hypothermia;
vaccinations (one of the causes of childhood ophthalmoherpes);
stress;
impaired or unbalanced nutrition.

At-risk groups

The herpes virus is present in an inactive state in the body of 90% of the population; potentially, every person can experience ophthalmoherpes. High probability of infection in:

pregnant women carriers of genital herpes;
newborns;
preschool children;
people who have undergone organ transplantation;
men, women, children with weakened immune systems.

Symptoms of ophthalmoherpes

General manifestations of the herpes virus in the eyes:

redness and itching in the affected areas of the eye (photo);
corneal sensitivity;
swelling of damaged tissues;
conjunctivitis and blepharitis in chronic form;
violation of the structure of the integument; erosive damage to the ocular mucosa;
rashes, blisters and sores around the organs of vision;
seals on the upper and lower eyelids;
blurred vision;
blurred, distorted perception of objects.

The listed symptoms are accompanied by photophobia, dry eyes, frequent blinking, sometimes fever and depressed health.

Clinical forms are represented by pathology of the anterior and posterior sections. The anterior section is affected by superficial and deep changes.

Damage to the primary layers includes:

inflammation of the conjunctiva and eyelids;
damage to the corneal layer (keratitis) with blistering, merging of ulcers, deformation of the edges of damage to the cornea;
erosive manifestations;
inflammatory processes in the connective tissue of the sclera.

Profound changes are diagnosed:

metaherpetic keratitis with a wide area of corneal damage;
deep keratitis with opacities in the cornea, changes, swelling and accumulation of fluid in the corneal layer.

In the posterior part, changes appear in the retina, optic nerve, and vascular layers. These include:

retinochoroiditis - focal white formation in the retina;
uveitis – inflammation of the vascular layer;
neuritis – irritation of the optic nerve;
acute necrosis - death of the retina;
ischemic retinopathy - stagnation of blood in the eye.

Which doctor should I contact?

Herpes with superficial manifestations can easily be confused with allergies or conjunctivitis. Only an ophthalmologist will be able to conduct a routine examination and confirm or refute the viral nature of the pathology.

Diagnosis of ocular herpes

The choice of diagnosing the disease is determined by the course of the disease and symptoms:

Fluorescent antibody method according to Kasparov. MFA is based on the injection of serum with antibodies into the conjunctiva. An increase in the glow of the solution's antibodies is characterized by the degree of herpes infection.
Biomicroscopy. Allows you to see keratitis damage to the corneal layer, blistering formations turning into erosion.
Non-contact tonometry. It is a measurement of intraocular pressure, an increase in which is characteristic of the posterior type of herpetic lesion.
Ultrasound. Used for pathology of the posterior region of the eye, it allows identifying vascular changes and lens opacities.
Ophthalmoscopy. It is carried out when examining the fundus of the eye for changes in the shape of the retina and the occurrence of swelling of the cornea.
Visometry or visual acuity testing. The classic way to detect changes in visual abilities is carried out when the optic nerve is affected by herpes.
Gonioscopy. The goal is to measure the cornea-iris, the presence of inflammation, foreign bodies and neoplasms in ophthalmic herpes.
Blood test for lymphocytes to prescribe treatment.
Linked immunosorbent assay. An increase in type M immunoglobulins in the blood indicates a viral disease.
PCR method through a smear from the mucous membrane of the eye.

Treatment for herpetic eye lesions

Procedures to eliminate ophthalmoherpes are dictated by diagnostic results. If the anterior zone of the visual organ and surrounding areas are affected, then a complex of drugs is used. Posterior eye pathology may require surgery along with medications.

Drug therapy

Treatment includes:

Antispasmodics and decongestants.
Immunomodulators.
Antiviral drugs.
Vaccination against herpes virus.

Immunomodulatory drugs are aimed at increasing the body's resistance to viruses. These include interferon inducers (Amiksin, Cycloferon) and immunoglobulins (Interlock). Amiksin (price from 600 rubles) and Cycloferon are prescribed in tablets and injections; they have a minimum number of contraindications. Interlock for eyes comes in drops. It restores the cell membrane and builds protection against the virus.

Antiviral agents for external use are creams, ointments and drops. Ointment (price from 20 to 100 rubles) is recommended with a 3% content of active substance, which is safe if it comes into contact with the mucous membrane. Fenistil Pencivir cream copes better with relapses, unlike Acyclovir, and is strictly applied to the eyelid. Oftalmoferon drops are prescribed in combination with ointments to prevent damage to the corneal layer of the eye. Viferon is prescribed to children.

Trifluorothymidine drops are safe and non-toxic. Ophthalmologists recommend them for their gentle and targeted action. Apply every hour, but in dosage due to possible damage to the retina. The price is within 300 rubles.

The tablet form of antiviral drugs is represented by Valtrex, Valvir, Zovirax (price about 500 rubles). Valvir is used to treat childhood herpes.

If necessary, symptomatic medications are added to the main treatment.

Painkillers are based on lidocaine, novocaine, atropine and reduce the unpleasant symptoms of herpes: burning, itching, pain, and also suppress swelling.
In case of acute damage with a possible bacterial nature, antibiotics are used.
Necrosis of tissue of the visual organ is treated with glucocorticosteroids, which are responsible for the regeneration of the epithelium.
Ocular herpes, accompanied by intraocular pressure, is treated with antihypertensive medications.
An integrated approach requires excluding possible allergies, so antihistamines Suprastin, Tavegil, Zyrtec are added.

Vaccination is carried out in the absence of complicated herpes 2 times a year.

How to get rid of eye herpes using folk remedies?

Traditional medicine recipes can be combined either in combination with drug therapy or independently.

Effective infusions for the eyes:

From lungwort. 2 tbsp. l. herbs are brewed in 500 ml of boiling water and left for 2 hours. The resulting infusion is used to wash the eyes for 2 weeks.
From arnica. Take 1 arnica inflorescence per glass of boiling water and brew for 2 hours. Make compresses from the resulting product and wash the eyes every 2 hours.

To increase overall immunity, drink chamomile and rosehip teas, add honey and lemon.

In addition to medicinal treatments, physiotherapy in the form of UHF is used to heal sores.

Complications of ophthalmic herpes

The following factors can aggravate the course of the disease:

mistaking pathology for another disease, for example, conjunctivitis;
refusal of examination and cytological tests;
incorrect diagnosis;
incorrectly formulated treatment.

This provokes the transition of eye herpes into a chronic form, which is dangerous:

Deterioration of vigilance and clarity of vision.
Decreased organ acuity.
Periodic pain in the eye area.
Chronic dry eye syndrome.

Acute lesions of the vascular layers and optic nerve with herpes can develop cataracts and glaucoma. Cases of complete loss of vision and disability are common.

Congenital herpetic infection causes exudation into the fundus and vitreous body. Affecting the blood vessels provokes perivasculitis. The neonatal period is accompanied by conjunctivitis, which develops into neuritis and necrosis of the layers of the eye.

Prevention

Basic measures to prevent the appearance of ocular herpes:

avoid contact with an infected person or affected areas of the body;
treatment of the birth canal of a woman in labor who is a carrier of genital herpes;
applying antiviral ointment to the eyes of a newborn if there is no information about the health status of the pregnant woman;
taking immunomodulators and multivitamins;
vaccination for secondary diseases;
hardening procedure and physical education.

The herpes virus can affect various human organs, including the eyes. Herpes on the eye is one of the most dangerous herpes infections, which can lead to serious vision impairment. This virus is also called ophthalmoherpes.

Most often, herpesovirus causes inflammation of the cornea of the eye - keratitis. For this reason, a person begins to lose vision quite quickly. According to statistics, in some countries the proportion of keratitis is more than 80%. Recurrences of ocular herpes can occur 3 to 5 times a year. In the absence of timely and adequate treatment, the inflammation process can involve the deep tissues of the eye, which often leads to complete loss of vision.

Photo

Causes of herpes in the eyes and methods of infection

The tear fluid of the eye protects quite well from infections if everything is normal. Secretory immunoglobulins, which are contained in tear fluid, prevent the spread of viruses.

In what cases is it possible to develop herpes on the eye:

A decrease in the immune system, which occurs due to severe stress, hypothermia, or previous infectious diseases.
Eye injury.
Pregnancy.
Taking immunosuppressants.

Initially, you can become infected with herpesvirus under the following circumstances:

Direct contact with a sick person – the virus penetrates through the mucous membranes of the mouth and genital tract.
Maintaining a common household - using the same dishes, personal hygiene products, towels, etc.

Initially, upon entering epithelial tissue, the virus multiplies and spreads through the circulatory and lymphatic systems, from where it moves throughout the body. Herpesvirus types 1 and 2 penetrate into the nerve ganglia, remaining there for life in a “sleeping” mode. This route of infection is endogenous.

There is a second route of infection - exogenous, in which the serous contents of herpetic vesicles enter the mucous membrane of the eye.

Most often, this route of infection occurs in childhood, since children have increased activity. The share of exogenous infection in childhood is 80%.

Clinical picture of herpes on the eye

Herpes on the eyelid is characterized by the following symptoms:
Redness of the eyeball, eyelids.
Excessive tearing.
Pain.

In the case of herpetic damage to the retina, in addition to the main symptoms, the following signs may be observed:

Blurred vision, feeling of blurred vision.
Flashes before the eyes.
Distortion of the visibility of objects.
Double vision.
Convulsive closing of the eyes.

Clinical forms

Name of the disease	Symptoms	Photo
Redness of the eyelids, the appearance of bubbles with clear liquid with further formation of crusts, burning of the skin, itching, temperature.
Herpetic rashes on the skin of the eyelids and nose, redness of the eye.
Significant decrease in the sensitivity of the cornea of the eye, photophobia, lacrimation, formation of bubbles on the cornea along the nerve fibers.
Herpetic lesion of the vascular tract, decreased sensitivity of the cornea, hyperemia of the iris, increased intraocular pressure, displacement of the eye “disc”.
Herpetic corneal ulcer	An ulcer on the cornea without pain.
Vitreous opacification, small centrally located precipitates.
Inflammatory lesions in the eye area, loss of vision.
Thickening of the cornea of the eye, lack of sensitivity of the cornea, significant impairment of vision, blisters.
Severe swelling of the conjunctiva, herpes rashes along the edge of the eye.

Diagnosis of ocular herpes

Eye diseases accompanied by inflammation have similar symptoms, which makes it difficult to determine an accurate diagnosis and begin treatment.

What is needed to diagnose the exact disease:

Visual examination of the skin of the eyelids, which reveals herpetic rashes.
Visometry (determining visual acuity) – often vision is greatly reduced.
Perimetry (test to determine the boundaries of the visual field).
Analgizemetry (testing the sensitivity of the cornea of the eye) - most often there is practically no sensitivity.
Biomicroscopy (examination of the anterior and posterior parts of the eyeball).
Ophthalmoscopy (examination of the fundus of the eye) to identify possible infections.

Laboratory confirmation is required, since visual symptoms may indicate an entirely different disease.

What diagnostic methods are required:

Scraping from the conjunctiva - this analysis determines antibodies to the virus.
Complete blood count – necessary to determine the level of leukocytes and lymphocytes. As a rule, their level is increased.
A fingerprint smear from the conjunctiva and cornea to determine the DNA of the virus.

Treatment of herpes on the eye

Treatment for herpes on the eyelid will depend on the severity and form of the herpes virus infection. If the symptoms of the disease are superficial, then herpes on the eye should be treated in two ways:

Causative therapy – removal of the active pathogen.
Symptomatic therapy – relief and further elimination of symptoms (itching, swelling, inflammation).

Of course, the main treatment is aimed at suppressing the herpes virus. To do this, they act in the following ways:

Antiviral drugs – Acyclovir, Gerpivir.
Specific immunotherapy – antiherpetic vaccine.

The maximum effectiveness of treatment lies in the combined use of medications aimed at suppressing the virus, eliminating symptoms and reducing possible relapses. Surgery is performed if the deeper structures of the eye have been affected.

Drugs for the treatment of herpes virus on the eyelid

Treatment of herpesvirus on the eye is carried out using drops and ointments, plus systemic administration of tablet drugs.

Valaciclovir - 0.5 grams orally 2 times a day.
Physiotherapy (local) - ultraviolet irradiation, UHF for speedy healing of wounds.
Antiviral drops – Oftan-IDU, 1 drop 6 times a day.
Antiseptic drops – Miramistin, 1 drop 6 times a day.
Anti-inflammatory drops – Naklof 1 drop 3 times a day.
Antihistamine drops (for allergic reactions) – Opatanol 1 drop 3 times a day.

The duration of treatment is 3-4 weeks strictly under the guidance of an ophthalmologist.

Prevention of herpes on the eye

Prevention of herpes on the eye consists of minimizing direct contact with a sick person, using individual hygiene items, dishes and cosmetics.

If herpes is detected in a pregnant woman, treatment and special treatment of the birth canal is carried out to avoid infection of the child during childbirth.

The herpes virus can infect almost all human organs, including the eyes. Painful sensations in the eyes, tearing and an unpleasant reaction to bright light. Herpes on the eyes is considered one of the most dangerous infections for humans. Not timely treatment of herpetic eye lesions leads to deterioration of vision. In addition, the disease has a second name, ophthalmoherpes.

Causative agents of ocular herpes

The main causative agents of ocular herpes are the following stamps:

Cytomegalovirus.
Chickenpox virus is a strain of Varicella zoster.
Herpes simplex virus (type 1).
HSV-2 – genital herpes.

In humans, the mucous membrane of the eyes is well protected from the penetration of harmful microorganisms. Class-A immunoglobulin is contained in large quantities in the tear fluid, and it is this fact that prevents the development of many ophthalmological pathologies.

A person who is a carrier of a dangerous virus has specific killer T cells circulating in his blood serum, purposefully working against the infection.

Risk group

At risk are:

People with low immune systems.
Women during pregnancy.
Patients with mechanical trauma to the eyeball.
Regular stressful situations.
Constant hypothermia.
Patients taking immunosuppressants, cytostatics, and drugs with prostaglandins for a long time.

Factors in the development of ocular herpes

Associated development factors are:

Frequent hypothermia, prolonged exposure to cold wind;
Chronic diseases;
Eye injuries;
Effect of ionizing radiation;
Stress, depression;
Disturbances in the functioning of the endocrine system;
Prolonged exposure to ultraviolet radiation on the eyes;
Formation of malignant neoplasms.

Ways of infection with ocular herpes

Endogenous route of infection with herpes of the eye. The virus, once on the surface of the epithelium, begins to multiply quickly and, as a result, spreads through the circulatory and lymphatic systems, from where it begins its rapid formation on a certain part of the body. Herpesvirus types 1 and 2 enter the nerve ganglia, remaining there forever, and are activated only with a sharp decrease in the immune system.

The second route of infection is exogenous, in which the pathogenic contents of the vesicles penetrate the mucous membrane of the eye. Almost always, this route of infection affects children, since the child’s body has increased acidity.

General signs

Symptoms of a cold on the eye are as follows:

Severe redness of the lower or upper eyelid;
Redness of the eyeball;
Nausea, urge to vomit;
Painful feelings, tearing of the visual organs;
It hurts a person to look at a bright light;
The appearance of small watery blisters;
Unbearable itching around the eyelids.

Clinical manifestations of ocular herpes

Clinical forms can be presented as follows:

Herpetic dermatitis. Stitching sensations, burning at the site of the rash, mainly on the cornea. Sudden appearance of transparent bubbles.
Keratoiridocyclitis. The disease negatively affects the blood vessels of the eyes. In the acute form, a person experiences eye pain and itching.
Herpetic conjunctivitis. Rashes in the form of blisters begin to appear on the eyeball, the eyes become very watery, especially in the morning, an unpleasant feeling of dryness in the eyes, when looking at bright light, the eyes hurt.
Herpetic ulcer of the cornea. The disease is asymptomatic, treatment is long-term.
Stromal keratitis. With pathology, there is a constant increase in eye pressure, the sensitivity of the cornea is reduced, small blisters appear, and herpetic damage to the eye vessels.

Important! The first signs of ocular herpes are very similar to most different eye diseases. And if we talk about the course of general symptoms, they can easily be confused with conjunctivitis, keratitis and many other viral pathologies. Be careful.

The first thing the doctor will ask you to do is a virological analysis of the watery rash. The doctor may also scrape near the eye. The analysis will help to quickly identify the virus that caused such a reaction.
PCR (polymerase chain reaction) study. This method will help to accurately determine the type of pathogen and prescribe effective therapy to the patient.
Blood analysis. This method allows you to determine the presence of a pathogen. As a result, the doctor finds out the nature of the pathology: receptive or primary.

Important! As soon as you notice the first signs of the disease and other unpleasant sensations in your eyes, you need to visit an ophthalmologist. If a person does not have such an opportunity, you can consult a general practitioner.

Groups of medications

Treatment of ophthalmic herpes should be comprehensive. Effective pharmacological groups are:

Anti-inflammatory drugs in the form of eye drops: Diklo-F, Indocollir, Naklof.
Antiviral drugs in the form of ointment drops: Acyclovir, Oftan-IDU, Okoferon (a rare drug and its price is unknown).
Antibacterial drops: Tobrex, Floxal, Oftaquix.
Antihistamines for the prevention of allergies: Opatanol, Sodium cromoglycate.
Antiseptic eye drops: Okomistin, Miramistin.
Vitamin complexes: Pikovit, AlfaVit.
Drugs to boost the immune system: Polyoxidonium.

Antiviral medications

Without antiviral therapy, treatment of ocular herpes makes no sense.

Oral use of antiviral drugs will quickly stop the development of the pathological process and the spread of rashes. In this case, the most effective are:

Valacyclovir. The medicine is intended for oral administration; you need to take one tablet three times a day. The duration of the course is from one to two weeks;
Acyclovir. The duration of the course is two weeks, take one tablet in two or three doses.

Trifluorothymidine is a safe and very effective treatment. It contains no chemicals, has a mild therapeutic effect, and acts specifically on the affected area. Experts prescribe the drug only if other medications are not suitable for any reason.

Important! With long-term use of Trifluorothymidine, damage to the cornea and all layers of the retina is possible.

Eye drops for the treatment of colds in the eyes

Okomistin is quite widely used in medical practice. You need to drop one drop into each eye six times a day. The entire course should take two weeks;
Miramistin. The product has antiviral properties. The duration of therapy with Miramistin should be from two to three weeks. You need to instill one drop six times a day. Can be used to treat a child from infancy.

Eye ointments

Before starting to use ophthalmic ointment, it is necessary to exclude the development of allergies or intolerance to the components of the product.

Effective pharmacological positions are considered:

Penciclovir must be applied to the location of the rash above or below the eye once a day;
Zovirax. It is necessary to put the ointment in the eyes in the morning and before bed for two weeks.

Immune agents for the treatment of ophthalmoherpes

Cycloferon. The product destroys the virus and is used for oral administration, one tablet for three weeks;
Reaferon. It has only natural composition with human interferon. The product is available in two dosage forms in the form of drops and a solution for injection. Not suitable for treating children.

Vaccination

Almost always used only as a preventive measure, the procedure is performed under the strict supervision of a doctor. Carrying out a vaccine allows you to avoid the risk of repeated recurrence of the sore, as well as protect the body from the negative effects of pathogenic microorganisms. It is worth paying attention to the following medications:

Herpovax;
Vitagerpevac;
Gerpevac.

Complication of ocular herpes

The inflammatory process can transfer to blood vessels (keratouveitis).
Perforation of the cornea of the eye leading to the development of complete blindness.
Sclerite formation.
Glaucoma.
Significant decrease in visual acuity.
Formation of purulent inflammation.

All of the above consequences of the eye are quite dangerous for humans.

– damage to the eyeball or appendages of the eye caused by infection with herpes simplex virus (HSV) 1, less often type 2. Clinical manifestations include lacrimation, pain, photophobia, blepharospasm, and the appearance of a “veil” or “fog” before the eyes. Diagnosis is based on identifying HSV using fluorescent antibodies, studying the nature of damage to the organ of vision using biomicroscopy, visometry, ultrasound of the eye, and tonometry. Antiviral drugs are used as etiotropic therapy. Additionally, NSAIDs, antibacterial drugs, reparants, antioxidants, glucocorticosteroids, and immunostimulants are indicated.

Ophthalmoherpes occurs with a frequency of 1:8000. 25% of patients with a primary lesion experience relapses. After repeated cases of herpes, a recurrent course is observed in 75% of cases. The ratio of the incidence of the primary and recurrent forms is 1:9. This pathology most often leads to clouding of the cornea and the development of corneal blindness. The prevalence of herpetic keratitis in the general structure of inflammatory diseases of the organ of vision among adults is 20-57%. In childhood, this figure reaches 70-80%. Males and females get sick with the same frequency. The disease is widespread.

Causes of ophthalmoherpes

The development of ophthalmoherpes is caused by infection with herpes virus type 1. In rare cases, herpes eye infections are caused by HSV type 2. The role of HSV type 6 in the occurrence of ophthalmic herpes has not been fully studied. Activation of a persistent virus in the body is facilitated by stress, traumatic injuries, infection, hypothermia, and hyperinsolation. At high risk are pregnant women with a history of herpes and people who have been treated with prostaglandins, glucocorticosteroids, and immunosuppressants. Injury to the cornea leads to deep erosion of herpetic origin.

Pathogenesis

The herpes virus most often affects the cornea. The nature of the development of secondary changes is determined by the viral load and the state of the immune system. It has been proven that pathology often occurs against the background of a deficiency of cellular immunity. The likelihood of virus penetration increases with a decrease in the production of interferon and secretory antibodies by subepithelial lymphoid tissue. Pathological agents can enter the tissue of the eyeball through exogenous, hematogenous or neurogenic routes. During exogenous penetration, the virus multiplies directly in the thickness of the epithelial layer of the cornea. The long course of cytopathic and degenerative-dystrophic processes leads to necrosis and rejection of corneal tissue.

In case of superficial damage, a small defect is formed, which subsequently epithelializes. This leads to persistence of the virus in the trigeminal ganglion and the membranes of the eye. Exposure to unfavorable factors causes the activation of pathological agents. With deep damage to the stroma, a direct cytopathic effect provokes its destruction with the concomitant development of an inflammatory reaction. The role of antigenic mimicry in the attachment of cross-reacting antigens, which entail the activation of autoimmune reactions, is being studied.

Classification

In most cases, ophthalmoherpes is an acquired pathology. Isolated cases of intrauterine infection with the development of symptoms in newborns have been described. In accordance with the clinical classification accepted in ophthalmology, the following forms of herpetic lesions are distinguished:

Primary. Occurs during primary infection. Isolated eye damage is often characterized by the involvement of only superficial layers in the pathological process.
Recurrent. Its development is due to the persistence of HSV in the body. Unlike the primary form, the recurrent course leads to unilateral damage.
Front. When the herpes virus infects the anterior segment of the eyes, conjunctivitis, blepharoconjunctivitis, keratitis and corneal erosion occur. Depending on the nature of the inflammation of the cornea, vesicular, tree-like, geographical and regional variants of ophthalmic herpes are distinguished.
Rear. The pathology of the posterior part of the eyes is represented by retinochoroiditis, chorioretinitis, optic neuritis, acute retinal necrosis syndrome, uveitis, and retinopathy.

Symptoms of ophthalmoherpes

The clinical picture of ophthalmoherpes is determined by the nature of the damage to the structures of the eye. With herpetic conjunctivitis, patients note redness, swelling of the conjunctiva and eyelids. Mucous and purulent discharge is accompanied by burning and itching of the eyes. With the tree form of keratitis, patients complain of increased lacrimation, blepharospasm, and photophobia. Pericorneal injection is associated with severe pain. The decrease in visual acuity is due to the localization of the lesion in the optical zone of the cornea. When the infection spreads to the anterior part of the choroid, the symptoms described above are accompanied by hyperemia and “floaters” before the eyes. Posterior uveitis is manifested by blurred vision and distortion of the visible image.

Herpetic iridocyclitis is characterized by a chronic progressive course. Symptoms of the pathology include visual dysfunction, the appearance of “fog” or “veil” before the eyes. The clinical picture of retrobulbar neuritis is dominated by complaints of severe pain in the orbital area with irradiation to the superciliary ridges, frontal and temporal areas of the head. With herpetic myositis of the oculomotor muscles, patients note that the movements of the eyeballs are severely difficult and are accompanied by severe pain. In most patients, relapses occur once a month or more often, which indicates a severe course of the pathology. Patients report a connection between relapses and previous psychological stress, hypothermia, and acute respiratory infections.

Complications

Severe herpetic keratitis is complicated by clouding of the cornea (16%) with further development of the corneal form of blindness (5%). Often, keratoiridocyclitis potentiates the occurrence of secondary ocular hypertension. In the stromal form of the disease with ulceration of the cornea, there is a high risk of inflammation of the membranes of the anterior part of the eyes (bacterial conjunctivitis, blepharoconjunctivitis, scleritis). In the chronic version of the pathology, a common complication is pan- or endophthalmitis. In 12% of patients, secondary cataract is diagnosed. The chance of glaucoma is 3%.

Diagnostics

The diagnosis is based on collecting an anamnesis of the disease, the results of laboratory and instrumental research methods. The herpes virus can be detected by using the fluorescent antibody method. The material for diagnosis is a biopsy of the orbital conjunctiva. The complex of ophthalmological examination includes:

Biomicroscopy of the eye. With dendritic keratitis, small bubble-like defects are visualized, which, after opening, lead to the formation of erosion. The edges of the affected area are raised and swollen. With a progressive course, the formation of perilimbal infiltrates is noted, which are pathognomonic for the geographical variant.
Non-contact tonometry. In the posterior form of the pathology, a persistent increase in IOP is observed, caused by the production of serous or serous-fibrinous exudate.
Ultrasound of the eye. Ultrasound examination makes it possible to identify posterior precipitates, signs of damage to the posterior parts of the uveal tract due to clouding of the optical media.
Gonioscopy. Allows you to visualize anterior synechiae and determine the presence of exudate in the anterior chamber in anterior uveitis of herpetic origin.
Visometry. Visual dysfunction is observed only when the defects extend to the optical center of the cornea.
Ophthalmoscopy. When examining the fundus of the eye, secondary changes in the retina and optic nerve head are detected in the form of swelling and local foci of hemorrhage.

Before prescribing immunotherapy, an immunological study is indicated to determine T- and B-lymphocytes in peripheral blood. Differential diagnosis of the posterior form is carried out with anterior ischemic neuropathy, central serous retinopathy. The herpetic genesis of the pathology can be suspected in the case of recurrent herpes of another localization in the anamnesis, preceding the visual symptoms of viral diseases of the respiratory tract.

Treatment of ophthalmoherpes

The main therapeutic measures are carried out by an ophthalmologist, aimed at suppressing the replication of virions and increasing the overall resistance of the body. Timely treatment begins to avoid the development of irreversible changes in the membranes of the eyeball. In the treatment of ophthalmoherpes the following is used:

Chemotherapy antiviral agents. For the superficial or stromal form of the disease with ulceration, local use of an eye ointment containing acyclovir and instillation of concentrated interferon are indicated.
Immunotherapy. Immunostimulants are used for chronic herpes infection, frequent relapses, and concomitant chronic diseases. Patients are advised to use a synthetic agent based on glucosaminil muralgyl dipeptide.
Dexpanthenol. It is prescribed in the form of a gel in the superficial form for the purpose of regenerating the cornea. Sometimes instillations of reparatives are recommended - taurine, sulfated glycosaminoglycans.
Antioxidants. Used to potentiate the therapeutic effect of reparants. Instillations of methylethylpyridinol 3 times a day are indicated.
Antibacterial therapy. Antibiotics are prescribed for necrotizing ophthalmic herpes and signs of bacterial complications.
Glucocorticosteroids. They are used upon completion of epithelization of the cornea or in the subacute stage, subject to active epithelization of the membrane. Pharmaceuticals are used topically or administered parabulbarly. Contraindicated in the acute phase of the inflammatory process in the presence of signs of ulceration of the cornea.
Antihypertensives. This group of drugs is indicated for increased intraocular pressure or objective signs of swelling of the membranes of the eye.

In case of prolonged or complicated course of the pathology, in addition to the main treatment, non-steroidal anti-inflammatory drugs, desensitizing drugs, vitamins, and antiseptics are used. The need for their use is associated with the participation in the pathological process of not only infectious, but also allergic and autoimmune components. To increase the effect of antiviral therapy, drugs are administered using physiotherapeutic techniques - magnetic and phonophoresis. During the period of clinical remission, surgical correction of secondary complications is indicated.

Prognosis and prevention

The outcome of the disease is determined by the characteristics of the eye damage. In severe cases, there is a high risk of irreversible vision loss. Timely treatment allows you to achieve complete remission. In order to prevent relapses during the period of “imaginary well-being,” it is recommended to administer a herpes polyvaccine under the control of immunological parameters. Nonspecific preventive measures are based on the treatment of herpes of other localizations, preventing contact with patients with herpes infection, increasing the general reactivity and resistance of the body.