Eye Herpes in Children

Herpes viruses can cause infections in many areas of the body. Eye herpes, also called ocular herpes, typically results from an infection with herpes simplex virus type 1 (HSV-1), also known as oral herpes. Once a person is infected with a herpes virus, it can become dormant, and then reactivate later. People who develop eye herpes commonly have recurring episodes, and the first incident often occurs during childhood.

Types

• HSV-1 is most commonly associated with cold sores, also called fever blisters, that occur on and around the lips. Herpes simplex virus type 2 (HSV-2) most often affects the genitals, and only rarely causes eye herpes. Herpes Zoster virus (HZV) is the virus which causes chicken pox, and can lead to outbreaks of shingles in adulthood. This form of herpes also can cause eye herpes. Children commonly are infected with HSV-1 during childhood by an adult, such as when an adult with a cold sore kisses the child's face.

HSV-1 Symptoms

• Most children infected with HSV-1 for the first time have no symptoms. Sometimes they develop blisters or ulcers in or around the mouth, along with a fever. When the infection reactivates, it typically causes a cold sore. HSV-1 also can cause patches of eczema on other areas of the skin, usually above the waist, and infections in the eyes. About one-third of patients who experience an eye herpes outbreak will have outbreaks in the future, according to the American Association for Pediatric Ophthalmology and Strabismus.

Eye Herpes Symptoms

• Eye herpes caused by HSV usually has symptoms of blisters on the eyelids that crust over within a week. The eye may be red and feel gritty, and the child may have blurred vision. There may be pain, tearing and sensitivity to light, and the child might have headaches during the outbreak. The child also may experience swelling in the cornea (keratitis). More serious cases involve the infection spreading to the middle layers of the cornea, which can cause permanent scarring, and inflammation behind the cornea in the uvea. Eye herpes caused by HZV has similar symptoms, but typically starts with a rash on the forehead and around one eye.

Treatment

• Physicians prescribe topical and oral anti-viral medications to reduce the duration of an eye herpes outbreak and decrease symptoms. Topical antibiotic ointment or drops also may be used to prevent bacterial infection. When the outbreak has affected the middle layers of the cornea or the uvea, the doctor typically prescribes steroid eyedrops. The doctor also may gently scrape the cornea to eliminate the diseased cells.

Neonatal Herpes

• Rarely, newborns can develop neonatal herpes. A parent with HSV-1 or HSV-2 transfers the disease to the infant before, during, or immediately after birth. Symptoms can be mild, but also can affect the central nervous system and become life-threatening. When neonatal herpes affects the eyes, doctors typically treat it with both topical and intravenous anti-viral medications, as well as topical antibiotics.