Herpes on the eyes ( ophthalmic herpes ) is a clinically complex phenomenon. It has several forms with its own symptoms. Therefore, self-medication is categorically not recommended, since it is necessary to treat herpes on the eye only after a correct diagnosis, which we will discuss below. Herpes can affect both the mucous membrane of the eyes and the eyelids or skin around the eyes. Below are all the features of getting the herpes virus on the eyes.

CAUSES OF INFECTION

The main causative agents of ocular herpes are HSV-1 (a virus that provokes a cold on the lips) and a virus – varicella zoster (chickenpox).

Secondary viruses that are also capable of causing ophthalmoherpes are herpes viruses: type 2 (usually causes genital herpes), type 5 (cytomegalovirus), type 6 (causes infantile roseola in the primary manifestation).

CAUSES AND METHODS OF INFECTION

To provoke the activity of the virus and its manifestation in the eye area can: treatment with cytostatic drugs, pregnancy, taking immunosuppressants.

External factors of infection can be: eye injuries; infection of the eyes with a virus in the active stage of a cold on the lips, if the bladder is damaged and the contents interact with the eye tissues.

The defeat of the eye area with ophthalmic herpes is possible with household contact, through hygiene items. For example, wiping yourself with a towel used by an infected person in the active stage of herpes on the lips. When applying makeup, for example, using a common infected attribute, transferring herpes to the upper eyelid.

If there is a frequent recurrence of herpes in the eye area, then this is usually due to a weakened immune system. Even if there was a clinical recovery, the herpes virus will remain (inactive) inside the body for a long time. And with reduced immunity, it will make itself felt, affecting the former areas.

GENERAL SYMPTOMS OF HERPES ON THE EYES

Symptoms and signs of ophthalmic herpes are very similar to many eye diseases. Especially if we talk about general symptoms, they are easily confused with conjunctivitis, keratitis and other bacterial inflammations.

As a rule, herpes of the eye and some other eye diseases have common symptoms:

Soreness and tearing;

Reaction to bright light;

Visual impairment (especially in the dark);

Redness of the eyelid;

redness of the eye;

Nausea and headache are possible;

Lymph nodes may be enlarged.

There are symptoms in which ophthalmic herpes can be distinguished from other eye diseases: pronounced blisters, the same as with herpes on the lips, as well as severe itching in the eyelids.

During a visual examination, several zones affected by the ocular herpes virus can be distinguished:

Herpes around the eyes – not only the eyelids are captured, but also skin areas in the left and right parts of the eyes;

Herpes above the eye – the defeat of the upper eyelid;

Herpes on the lower eyelid of the eye – all the same bubble rashes;

Damage to the mucous membrane of the eye;

Herpes under the eye – rashes extend beyond the lower eyelid.

Herpetic dermatitis.

Tingling and itching in the area of small rashes. After that, vesicles (clear vesicles) appear.

After a few days, the vesicles form a yellowish crust.

Sometimes the temperature may rise.

The patient feels unwell and weak.

Herpetic conjunctivitis.

Bubble rashes begin with a lesion in one eye.

There is a clear discharge from the eyes, from which the eyelids stick together in the morning.

Bright light hurts the eyes.

Sensation of dryness in the region of the eyeballs.

Redness of the conjunctiva.

Bubble rashes may appear on the cornea.

Keratoiridocyclitis .

The disease affects the vessels of the eyes.

In acute form, eye pain expressed by periods.

With a recurrent form of pain is not observed, but visual acuity gradually decreases.

This form of herpes is the most difficult to cure.

Stromal keratitis.

The sensitivity of the cornea is reduced.

There is a feeling of a foreign body in the eye.

Increased eye pressure.

There is a sensation of a displaced eye disk.

Presence of water blisters.

Herpetic lesions of the eye vessels.

Herpetic ulcer of the cornea.

The disease lasts for a long time.

The ulcers appear to be clean.

The disease is painless.

Acute retinal necrosis.

Most often it is asymptomatic.

Sometimes there is pain.

There is a deterioration in vision.

Herpetic keratitis.

Edema of the corneal tissues.

The appearance on the cornea of \u200b\u200bbubbles characteristic of herpes.

Photophobia and lacrimation.

Significantly reduced sensitivity of the cornea.

The cornea loses its luster due to the formation of irregularities that are caused by herpes sores, so turbidity is observed.

Postherpetic trophic keratitis.

There is a thickening of the cornea and the absence of its sensitivity.

Rough and slightly raised epithelium.

Herpetic vesicles periodically disappear and reappear.

The disease is protracted and is accompanied by visual impairment.

CORRECT DIAGNOSIS OF OPHTHALMOHERPES

Following from the above clinical forms of ocular herpes and their similar symptoms, it is necessary to conduct a thorough diagnosis. After the diagnosis of the disease, the ophthalmologist will deal with the treatment. Below we describe the methods of diagnosing the disease, which can be carried out in herpes centers or clinics that provide services for the following types of diagnostics and tests.

Slit lamp. This method is mandatory when diagnosing herpetic eye lesions. When viewed with a lamp, a cornea lesion is detected with pronounced symptoms that occur during a herpes infection. These include: inflamed vessels of the eye, focal opacities, etc.

Immunofluorescence analysis (RIF). To examine the biomaterial under a fluorescent microscope, the cells of the affected area are taken, treated with antibodies (labeled with fluorochrome ) to herpes viruses. Then, when analyzed under an ultraviolet lamp, the herpesvirus cells are isolated by luminescence. If they are not, then the analysis is negative. This is one of the most accurate types of diagnosis of ophthalmoherpes to date .

Linked immunosorbent assay. It is carried out in especially severe cases of manifestation of eye herpes, or in case of doubtful determination of other types of diagnostics. In case of herpetic infection of the eyes, as a rule, immunoglobulins M are present. When examined in two stages (an interval of 2–3 weeks) , a 4-fold increase in IgG titer indicates the presence of ophthalmoherpes , and low-avidity may indicate the nature of the disease . IgG .

Do not forget that for a better and more accurate diagnosis of the disease, it is desirable to take biomaterial at an early stage of symptoms. And also a timely appeal to a specialist will help to avoid complications.

TREATMENT

How to treat herpes on the eye depends on the clinical form, which is why correct diagnosis is needed. For forms with lesions of the upper tissues, drugs are usually used to relieve symptoms, which can drown out the activity of the virus.

There are 4 groups of drugs that are usually taken in combination in the treatment of ophthalmic herpes :

Means for relieving symptoms (drugs against edema, painkillers, etc.).

Immunomodulators.

Antivirals.

antiherpetic vaccine.

With the penetration of herpes into the deep tissues of the eyes, surgical treatment is used:

removal of affected areas;

laser coagulation (radiation exposure).

Immunomodulators

Most often, eye herpes manifests itself when the virus is activated, which occurs when the immune system decreases, so the doctor, as a rule, prescribes immunoglobulins and interferon inducers for the immune correction of the body:

Interlock . Drops based on donor blood cells. Leukocyte interferons carry out the modification of cell membranes, which allows you to create a protective blockade of the cell to the penetration of the virus.

Reaferon . Drops that also contain human interferons. They are used in two ways: a) instilled into the eyes, b) injected in the affected area.

Interferon inductors: Amisksin , Cycloferon, Timalin, etc. They are used both in the form of tablets and by injection. Unlike immunoglobulins, interferon inducers practically do not cause allergic reactions and have a minimal list of side effects.

Antivirals

Drug    Description

Topical preparations

Acyclovir (ointment) 5% or 3%

When using a five percent acyclovir, it is necessary to exclude any possibility of getting the ointment on the mucous membrane of the eye. Apply only to the outer surface of the eyelids.

If you still allow the ointment or cream to get on the cornea or conjunctiva, then it is better to use a three percent acyclovir.

With repeated diseases of herpes is ineffective.

It is convenient to use for herpes on the eyelids to protect yourself from accidental contact with the mucous membrane.

Fenistil-pencevir (cream).

It is also impossible to allow contact with the mucous membrane of the eyes and treat only the outer part of the eyelids or the skin near the eyes.

This drug fights herpes viruses much better, so for recurrent herpes or a more acute form, it is better to use it.

Oftalmoferon (drops).

It is usually used in parallel with the application of acyclovir or fenistil , in order to prevent the possibility of the spread of herpes to the cornea.

When used for prophylactic purposes, therapy is carried out for 14 days, instilled into the eye – 2 drops 3 times a day.

Preparations in tablets

When ingested, the substances of these tablets are converted into Acyclovir. But the concentration of Acyclovir in this case can only be compared with the injection of the drug. Thus, the activity of the drug is much higher.

When fighting a strain of herpes that is insensitive to Acyclovir, Valaciclovir preparations will also be useless.

These are expensive pills relative to other herpes drugs, but the most effective.

To date, the drug Famvir is not recommended for use in children.

Acyclovir or Zovirax tablets .

The difference between these drugs is only in price and manufacturer, they contain the same active substance.

The weakest drug against eye herpes. More than half of the virus strains have low sensitivity against it. Typically, these tablets are used to prevent or treat HSV in the initial stage.

HSV vaccine for ocular herpes

With herpes on the eyes, vaccination can be carried out only in the absence of an acute form of the disease. Re-vaccination can be after 6 months. In this case, we are talking about a vaccine that was created using HSV types 1 and 2.

There are several herpes vaccines. Popular is Vitagerpavak of Russian origin. It is placed in the forearm area, the course includes 5 injections with an interval of 7 days with good tolerability of the drug. Then it is recommended to repeat the vaccination in six months.

Do not forget that with herpes on the eye, treatment can only be prescribed by an ophthalmologist after a correct diagnosis. Self-treatment of this type of herpes is highly discouraged. Improper therapy can lead to loss of vision. At the first manifestations of the disease, contact a specialist!

OPHTHALMOHERPES IN A CHILD

The causes of herpes in the eyes of children can be:

Vaccinations;

Overheating (including in the sun);

Hormonal changes;

Minor injuries, eye injuries;

Cold or hypothermia;

Decreased immunity.

Peculiarities of symptoms in children. In addition to itching in the eyelid, watery eyes, sensation of a foreign body in the eye and redness, in children, herpes in the eye area is usually accompanied by a cold on the lips, pay special attention to this. Before you contact a specialist, in the form of first aid for a child, you can carry out symptomatic treatment with Ophthalmoferon drops . Keep in mind that children may be more likely to get sick if they get chickenpox.

Features of treatment in young children. For the treatment of herpes on the eye in babies, as well as newborns, a bunch of drugs are most often used: Acyclovir (3% ointment), Viferon suppositories and Oftalmoferon drops . But a more detailed treatment can be selected only by knowing the degree of damage and the form of ophthalmic herpes .

56

COMPLICATIONS

If the treatment of eye herpes is started on time and after the correct diagnosis, the appropriate treatment was prescribed, then complications are unlikely. But if the herpes affected the eyes in deep tissues, then this can affect vision up to blindness.

Incorrect diagnosis, and, accordingly, incorrectly selected treatment, as well as untimely access to a doctor, can lead to the following complications:

Decreased clarity (clearness) of vision;

Constant feeling of dryness in the cornea;

Poor eyesight;

Cyclic eye pain;

An eye affected by herpes may eventually stop seeing at all.

With a long course of the disease, the virus can provoke cataracts or glaucoma. It is also possible detachment of the retina due to hemorrhages, which are characteristic of its defeat.

RECURRENCE PREVENTION AND MANAGEMENT

With relapses of almost any disease directly related to herpes viruses, the patient can only support the body with the help of constant intake of antiviral drugs. Indeed, at the moment there is no vaccine or medicine that can completely rid the body of herpes. Therefore, taking drugs is aimed at preventing and combating frequent relapses.

Knowing that ophthalmoherpes is caused by strains of the virus known to us, we can reduce the risk of the disease by vaccinating against chickenpox ( Varicella zoster ) in children and, accordingly, when vaccinated against herpes zoster (the causative agent is also Varicella zoster ) in adults.

So, you must remember that the treatment of herpes in the eyes should take place after its appointment by an ophthalmologist, and not at home. Do not forget that it is possible to damage not only external tissues (herpes virus on the upper eyelid, lower and around the eyes), but also deep ones, the symptoms of which are almost impossible to recognize at home. When visiting the clinic, the doctor will tell you in more detail about the symptoms and treatment of a specific form of ophthalmoherpes , will diagnose and select the right treatment. If, after reading the article, you find similar symptoms in yourself, we advise you not to delay and make an appointment with a doctor as soon as possible.