Transmission Routes The virus enters the body through mucous membranes and skin. Therefore, close personal contact is required for transmission. We typically contract the virus from cold sores and secretions on the lips during childhood. By the age of five, 60% of the population is infected with Herpes. It is reported that 20-45% of the world population has had cold sores on the lips. The disease is not transmitted through the air or swimming pools. When the disease is first acquired, only 1-6% of cases show symptoms. In other words, if you come into contact with someone who has a cold sore, the virus can be transmitted to you. You have a 1-6% chance of developing a sore within 3-9 days, and a 94-99% chance of not developing one. However, the virus remains in your body. The site of settlement is the part of the sensory nerve in the face called the “ganglion.” Subsequently, when your immunity weakens, the virus can move to your lips or eyes and cause the disease.
Frequency of Recurrence 10% of individuals experience eye herpes recurrence within one year, and 23% within two years. The more attacks you have had, the higher the chance of recurrence in the future. The frequency of attacks is not related to gender or the age at which the first outbreak occurred. Recurrences occur more often between November and February. The frequency of eye herpes in the community is 149 per 100,000.
Causes of Recurrence of Eye Herpes The virus is mainly located in the nerve ganglion. However, it can also settle in the cornea. Stress, fatigue, and sorrow can lead to the recurrence of eye herpes. Sunlight, trauma, surgery, temperature changes, febrile illnesses, menstruation, other infections, emotional stress, and some glaucoma medications (Prostaglandin F2 analogues) can also activate the herpes virus. Having eye herpes in both eyes indicates a problem with the immune system.
Symptoms of Eye Herpes
Redness and blisters on the eyelids (herpetic blepharitis)
Conjunctivitis: Follicular conjunctivitis manifests itself with redness and discharge in the eyes.
Cornea (the transparent outer layer of the eye): It causes various forms of disease such as infectious epithelial keratitis, neurotrophic keratopathy, stromal keratitis, and endotheliitis. It affects one eye and only affects both eyes in 3% of cases. 40% of individuals with both eyes affected are atopic (allergic). When the cornea is affected, there is pain, light sensitivity, tearing, and varying degrees of vision loss.
Uvea: Iridocyclitis manifests itself with redness, pain, and blurred vision.
Diagnosis Standard eye examination is sufficient to make a diagnosis. Samples are taken from the eye for other diagnostic methods: The sample is stained by pathologists. Cell culture, immunological tests, PCR, and electron microscopy examinations can be performed.
Treatment Depending on the type of disease, antiviral drops-ointments, corticosteroid drops, and antiviral pills are used in treatment. Eye herpes in the cornea can resolve without leaving any marks, but it can also affect the cornea more deeply and permanently reduce vision. In some cases, the cornea can be perforated due to the sore. In such cases, the cornea is repaired with a procedure called tissue adhesive application. When permanent marks remain on the cornea, corneal transplantation is required to improve vision. The success rate of corneal transplantation for eye herpes is around 50-80%. The main factors limiting the success of corneal transplantation are vascularization of the cornea and the virus affecting the transplanted new cornea.
