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What is Herpes Keratitis?

By J.M. Willhite
Updated May 17, 2024
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Herpes keratitis is an eye infection that causes corneal inflammation that can result in blindness if left untreated. Individuals who develop this ophthalmic viral infection have been exposed to the herpes simplex virus (HSV), which is commonly known to cause facial and genital lesions. When HSV settles in the eye, it can induce a variety of inflammatory symptoms that may contribute to impaired vision and corneal scarring. Treatment for herpes keratitis depends on symptom severity and may range from the administration of medicated eye drops to surgery. There is no cure for herpes keratitis.

When an individual contracts the herpes simplex virus, the infection may spread to the ocular region through either direct or indirect contact. Direct transmission of this viral infection may occur when one comes into contact with an open, herpetic lesion and fails to wash his or her hands prior to touching his or her eye. Indirect infection occurs when the HSV spreads to the eye on its own. Though herpes keratitis lesions are generally found on the cornea and eyelids, lesions may form anywhere in the ocular region.

Symptomatic individuals will generally receive a diagnosis of herpes keratitis once several tests have been completed. An extensive eye exam will usually be performed first to evaluate the overall condition and functionality of the eye, as well as the individual's visual acuity. In the presence of inflammation or other signs indicative of infection, corneal cell samples may be obtained for laboratory analysis. If the individual has pronounced ocular discharge, a sample of the secretion may be taken for evaluation. Additional testing may include the use of light and magnification to further assess the condition of the inner eye, including the lens and cornea.

The development of herpes keratitis-induced corneal lesions can cause a wide range of signs and symptoms that may adversely impact one’s vision. It is not uncommon for symptomatic individuals to experience pronounced inflammation, irritation and swelling in the affected eye. Some may develop excessive tear production, discomfort, or may experience difficulty blinking. If left untreated, symptoms can worsen, leading to chronic inflammation that contributes to corneal scarring and the possibility of permanent vision loss.

Treatment for herpes keratitis is entirely dependent on the severity of one’s infection. Individuals experiencing mild presentations of the herpes keratitis may be prescribed oral and topical antiviral medications to alleviate inflammation and promote healing. Extensive lesion development may necessitate corneal scraping to prevent long-term ocular damage. Scarring that significantly impairs one’s vision may require a corneal transplant to restore proper vision.

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