Herpes Keratitis

Eye Health

By Dr S.S. Gill

Ipoh Echo’s EYE HEALTH series continues with Consultant Eye Surgeon Dr S.S. GILL talking to us about HERPES of the eye.

Herpes of the eye is a viral infection of the eye caused by the Herpes Simplex Virus (HSV). It is a common infection. There are two kinds of herpes simplex viruses.


It can be divided into:

Type I Herpes – most common type. It mainly infects the face/lips and results in the “cold sore” formation.

Type II Herpes – less common. This is the sexually transmitted variety. The primary infection is in the genitals.

The eye can be infected by both types. However, most of the time it is the type 1 variety that infects the eye. The Type I variety of herpes is very contagious. It can be by skin contact with someone who has the virus. It is estimated that almost 90% of the population would have suffered from the type 1 variety during childhood.


The herpes virus spreads very easily. The eye commonly gets infected when an infected person touches an active sore or blister, after which he or she touches his eyes. It may be transmitted by the infected person himself into his or her own eye or from one person to another.


Symptoms may either be a painful sore over the eyelid or a painful red, and watery eye with blurring vision in some instances especially if it infects the clear transparent part of the eye called the cornea. In severe cases, it may also infect the inside of the inside of the eyeball although this is not as common as the former. Photophobia or sensitivity to light may also occur. The ophthalmologist will instil a fluorescein stain into the affected eye to detect the infection using a special blue cobalt light (see adjacent pic).


After the first infection, the virus remains dormant or inactive for months or even years until such time there may be an exposure to some trigger factor such as the following:

  • A prolonged illness or an injury
  • Steroid consumption for another illness
  • Usage of steroid eyedrops (without supervision)
  • Ahigh fever (unrelated to the eye)
  • Prolonged exposure to stress
  • A weak immune system
  • Those receiving chemotherapy or radiotherapy for a malignancy.


If the eye infection is detected early and the virus infection is infecting the cornea (clear transparent area) superficially only, it often heals well. However, if the cornea is involved more deeply, the infection may lead to scarring of the cornea, loss of vision and sometimes even blindness

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