Signs & Symptoms of Herpes Keratitis

The type 1 herpes simplex virus (HSV-1) causes cold sores on the mouth. It is contagious and can be transferred to the eye by touching a cold sore or blister and then your eye, which causes herpes keratitis. Approximately 450,000 people in the U.S., or 0.15 percent of the population, develop herpes keratitis each year, which is most common in adults. Recurrent herpes keratitis is a leading cause of corneal blindness, with reports of any visual disability as high as 40 percent, according to physician Robert H. Graham, Department of Ophthalmology, Mayo Clinic, Scottsdale, Arizona. Symptoms range from minor irritation and redness to loss of vision to eventual blindness if left untreated. Herpes keratitis almost always occurs in only one eye, typically infecting the eyelids, conjunctiva (the thin, transparent tissue that covers the outer surface of the eye) and cornea. Read on for the signs and symptoms of herpes keratitis.

Skin rash

• According to Gisela Torres, staff physician of the Department of Dermatology at University Hospitals of Cleveland, nearly 80 percent of the general adult population in the U.S. contracts the herpes simplex virus by early childhood. It typically shows up as a vesicular skin rash, resulting in a cold sore or blister in or around the mouth, but sometimes affecting the skin of the eyelids. After primary infection, the virus tends to remain dormant within the nerves of the body, later becoming reactivated during emotional or physical stress, overexposure to ultraviolet light (such as tanning) and/or in conditions of immune-compromise (such chronic diseases as cancer and AIDS). Vesicular skin rashes are less common during recurring infections.

Photophobia

• One sign of herpes keratitis is photophobia—a sensitivity to sunlight or well-lit places. You may find yourself actively avoiding light in order to alleviate discomfort or pain due to light exposure. However, photophobia isn't necessarily a symptom of just herpes keratitis. It is a fairly common symptom that may be caused by wearing contact lenses too long, burns to the eye, migraine headaches or drugs, among others.

Epiphora

• Epiphora is an overflow of tears—usually caused by insufficient drainage of the tear film from the eye. Everyone experiences overflow of normal tears occasionally, but if you notice that you have chronic excessive tearing, consult your eye doctor. While epiphora is caused by herpes keratitis, it may be the result of a variety of conditions.

Uveitis

• A common sign of herpes keratitis that occurs most often in recurrent infections is uveitis, an inflammation of the middle layer of the eye, the uvea. Uveitis symptoms, along with redness, irritation and blurry vision, include dark, floating spots along your field of vision.

Blurred vision

• Depending on how long you’ve had herpes keratitis, you may experience blurred vision. This is usually one of the first signs of herpes keratitis, but as infection progresses, the herpes virus begins to deaden the nerves of the cornea, numbing the pain. You might begin to believe that the infection is getting better, while actually, the virus is growing and eating away at the corneal surface. This level of infection may lead to scarring of the cornea, loss of vision and sometimes blindness if left untreated.