What is eye herpes and how to quickly cure it? Proper treatment of herpes on the eyelids and possible complications for the mucous membrane of the eye Herpetic lesions of the eyelids

Herpes on the eye (ophthalmoherpes) is a contagious disease. The herpes virus is present in 99% of people. But it is activated with the manifestation of characteristic symptoms only with weakened immunity.

Many people have experienced herpetic rashes on the lips and skin around the mouth. Does herpes occur on the eye, is it dangerous? on the visual organ - a characteristic symptom of ophthalmoherpes. Ocular herpes is dangerous because it affects the cornea and deeper structures of the eye. This leads to visual impairment and in severe cases leads to blindness.

Ophthalmoherpes is caused by herpes viruses. With sufficient immunity, the virus lives in the nerve ganglia without manifesting itself. When the protective function of the immune system decreases (hypothermia, prolonged colds, immunodeficiencies), the virus can wake up. In more than 70% of cases, type 1 herpes is activated. Less than 30% are viruses of other types: cytomegalovirus, chickenpox, genital form.

Adults are characterized by activation of the herpes virus already present in the body. In children, ophthalmoherpes often develops through contact with a sick person, when a large amount of infected biomaterial gets on the visual organ. This happens when sneezing, coughing, during contact children's games.

Classification

Ophthalmoherpes can be located in different places: herpes under the eye, above the eye, directly in the visual organ itself. The types of disease depend on the location of herpetic vesicles:

1. Herpes on the eyelid - dermatitis. Visually, red eyelids are observed with herpes in an adult in combination with swelling. May be accompanied by damage to the conjunctiva -.
2. Conjunctivitis is a herpetic lesion of the mucous membrane of the eye.
3. - damage to the cornea. There are stromal, trophic types of keratitis, corneal ulcer. Herpes on the cornea of ​​the eyes has dangerous complications.
4. Virus infection of the choroid, iris, and ciliary body is called herpetic uveitis.
5. Retinal necrosis is an irreversible damage to the structure of the retina.
6. Neuritis is damage to the optic nerve.

There are epithelial form (superficial lesion), tree-shaped (the lesion looks like the branches of a tree), geographical (similar to a geographical map), discoid (areas of damage to the cornea, shaped like discs).

The deeper the herpes virus penetrates, the more serious the consequences. It is necessary to begin antiviral therapy and strengthen the immune system as early as possible.

Watch the video showing different types of ocular herpes in a photo collage:

Causes of the disease

The appearance of herpes on the eyelid is caused by a disorder of the immune system. Reasons for decreased immunity:

• colds;
• frequent hypothermia or overheating;
• severe course of chronic diseases;
• hormonal diseases;
• stress;
• treatment with immunosuppressants, cytostatics (drugs that destroy cells of the immune system);
• pregnancy, postpartum period;
• primary and secondary immunodeficiency;
• contact with contaminated hygiene items: towels, cosmetics; with contaminated toys;
• trauma to the visual organ.

One or a combination of several reasons may not cause herpes. This happens depending on the individual characteristics of the body. Some people live and do not know about the presence of the virus, and some experience exacerbations several times a year.

Symptoms of the disease

Herpes begins with general symptoms. The incubation period is from 2 days to 1 week.

If herpes affects the skin, a burning sensation appears, the skin turns red and itches. When the virus is localized on the mucous membrane of the eye, lacrimation, redness of the conjunctiva, photophobia, and discharge from the eyes are observed. If the cornea is affected, then these symptoms include (involuntary closing of the eyelids), a feeling of sand in the eyes, and blurred vision.

When herpes is activated in the eye in the deeper layers, the symptoms become more pronounced: pain appears when moving the eyeballs, flashing flashes, blurred vision, double vision, a sharp deterioration in visual function, and headache.

At the end of the incubation period, typical signs of herpes appear - painful rashes in the form of blisters with clear liquid. The contents of the bubbles become cloudy after a few days. The bubbles burst and a crust forms after them.

A herpetic infection is characterized by enlarged lymph nodes and sometimes an increase in body temperature. Symptoms of the disease persist for 3–5 days. Then recovery occurs if complications do not develop.

Diagnostics

Early diagnosis allows you to quickly establish the correct diagnosis and prescribe treatment. During the examination, the doctor will make a diagnosis for typical manifestations of herpes on the upper or lower eyelid, conjunctiva, or on the eyeball. Additionally, laboratory and instrumental diagnostic methods will be required:

1. Biomicroscopy. The ophthalmologist examines the fundus through a slit lamp. Evaluates the condition of the retinal vessels, localization, prevalence, nature of pathological foci.
2. Immunofluorescence reaction (RIF). The doctor takes scrapings from the affected areas around the eyes or from the conjunctiva. With a deeper localization of the process, discharge from the eyes is taken for examination. The resulting material is then treated with special fluorochrome-labeled antibodies. Fluorochrome is a synthetic compound that creates a visible glow when exposed to ultraviolet light. If the virus is present in the biomaterial, then the doctor will see a glow under ultraviolet light.
3. Enzyme-linked immunosorbent assay (ELISA). Allows you to determine the presence of immunoglobulins M and G in the blood. Immunoglobulin M is responsible for acute processes in the body, immunoglobulin G for chronic ones. That is, if you only have the second type, this indicates the presence of the virus in an inactive stage. If both types are identified, this indicates an exacerbation of the infectious process. If only the first type, then this is a primary infection at an early stage.

How and with what to treat herpes under the eye

Herpes of the eye requires complex treatment. Therapy should combine antiviral agents in the form of tablets and eye ointments, drops, immunomodulatory drugs (based on immunoglobulins, interferon inducers), symptomatic agents (for moisturizing, relieving inflammation).

Sometimes antibacterial agents are required.

1. Antiviral tablets: Acyclovir, Zovirax, Famciclovir, Valacyclovir.
2. Antiviral ointment "Acyclovir", cream "Fenistil Pentsivir", antiviral drops with immunomodulatory effect "Ophthalmoferon".
3. Immunomodulatory drugs: Interlock drops, Gerpferon ointment, Viferon rectal suppositories, Cycloferon tablets, Reaferon injections.
4. Antibacterial agents for secondary infections: ointments “Tetracycline”, “Erythromycin”, drops “Tobrex”, “Albucid”, “Floxal”.

Symptomatic drops:

• To moisturize and accelerate healing for herpes: Visin eye drops.
• To relieve allergic manifestations: “Opatanol”.
• To relieve inflammation: “Indocollir”.

During the period of remission, when there are no clinical manifestations of infection, you can use the antiherpetic vaccine: “Vitagerpavak”, “Gerpovax”. The vaccine is created from inactivated viruses of types 1 and 2. It is administered several times at certain intervals. Recommended for frequent relapses of infection.

Folk remedies

Treatment with folk remedies will help ease the course of herpes. To wash the eyes, use an infusion of rose hips and marshmallow flowers. Soak cotton pads in the prepared infusion, cooled to room temperature, and wipe your eyes. You can fill a container with infusion and blink.

Raw potatoes, finely grated, can be applied as a compress. For compresses, dill juice and diluted aloe juice are suitable. To do this, 1 part of aloe leaf juice must be mixed with 10 parts of boiled water.

Folk remedies relieve burning sensation, reduce signs of inflammation, and soothe the skin. Do not use aggressive ingredients: garlic, alcohol-containing tinctures. They will harm the affected areas. The positive effect of traditional herpes therapy can only be obtained when combined with medications.

Features of treatment of herpes in a child

A peculiarity of herpes infection in children is that herpes on a child’s eye often begins with lesions on the lips. Then, when scratching the blisters, the child can introduce the virus into the visual organ. To do this, simply rub your eyes with pens containing the virus. Ophthalmoherpes is possible with chickenpox (chickenpox).

Newborns are prescribed immunomodulatory drops "Derinat". For older children - Oftalmoferon drops, Viferon suppositories, 3% Acyclovir ointment. "Acyclovir" in children under 2 years of age is prescribed only in a hospital setting.

Complications and prognosis

Early initiation of antiviral therapy in combination with the correction of immune disorders provides a positive prognosis. Full recovery is achieved.

Bursting blisters on the skin near the eye form a crust. If you don’t rip it off, it comes off on its own, leaving no traces. When an infection occurs, suppuration develops, which is treated with antibacterial drugs.

Severe complications develop if herpes penetrates into the deeper structures of the visual organ: it affects the vessels of the eye, the retina, and the nerve. Possible complications:

• retinal disinsertion;
• hemorrhages;
• complete or partial blindness;
• secondary cataract;
• increased intraocular pressure (glaucoma).

Video: doctor about the disease

We invite you to watch a video where an allergist-immunologist will talk about ophthalmoherpes, the reasons for its occurrence and methods of treatment:

Prevention

To maintain a good immune system, you need to eat right. Your daily diet should contain fruits and vegetables. In spring and autumn, it is recommended to take a course of multivitamins. Take a walk in the fresh air every day. Play sports. Master the technique of hardening the body.

During an exacerbation of the process, use individual hygiene products, limit household contamination through common objects, ventilate the room more often, and carry out wet cleaning.

When the first signs of illness appear, start antiviral treatment as early as possible. This can stop the process at an early stage. If herpes regularly gets worse, then take a long course of anti-relapse therapy. It lasts several months and promotes stable remission.

, usually affecting the cornea of ​​the eye.

Doctors warn to take herpes lightly, no matter what form it manifests itself. If we are talking about the eyes, treatment should be approached with special responsibility - the disease can lead to loss of vision, and in the most difficult cases, to blindness.

Unfortunately, a relapse of this disease is not uncommon: medicine knows of cases when sluggish ophthalmoherpes, having accumulated strength, attacked a person exhausted by an unpleasant and dangerous disease 3-5 times during the year.

We talked about what remedies exist for treating herpes on the face.

Thanks to the tear fluid - it contains secretory immunoglobulins that reliably protect our eyes from various infections. Her strength, unfortunately, is not enough if the immune defense of the body as a whole weakens.

In such circumstances, ophthalmoherpes quickly finds the “weak link” and manifests itself in all its “glory.”

The immediate impetus for the start of his hostilities is:

• eye injuries;
• contact with a sick person;
• using the same hygiene products with the patient;
• use of immunosuppressants.

An outbreak of the disease can occur in a pregnant woman, since during pregnancy the body undergoes dramatic changes and the immune system weakens.

Experts identify two methods of infection: endogenous (viral herpes, having entered the body, under favorable circumstances, manifests itself in various areas, including on the cornea of ​​the eye or on the eyeball) and exogenous (the infection enters the mucous membrane of the eye from the outside).

The second option is more common in children than in adults, because children constantly violate the rules of hygiene, participate in general games and can easily catch some kind of infection.

According to medical statistics, 80 percent of infections in young patients occur through exogenous infection.

If a primary infection has occurred, the incubation period lasts from 2 to 7 days.

The disease begins with the same symptoms as an allergy or bacterial infection (for example, conjunctivitis), and it looks very similar.

Here are some characteristic signs:

• the inflamed area itches;
• the eye is swollen;
• tears flow;
• the eye reacts painfully to bright light;
• Redness can be on the eyelids, on the skin around the eyes, and on the eyeball.

When the initial stage passes and the disease affects the retina, symptoms characteristic of ophthalmoherpes:

If the herpetic lesion continues to develop, turning into neuritis, the following symptoms may be added to the listed symptoms:

• debilitating pain in the eyebrow area;
• narrowing of the field of view;
• a blind spot in the center of the “picture” that a person sees.

Externally, the rash resembles herpes simplex and herpes zoster. Fluid-filled blisters can be located on the upper eyelid or on the inside of the eyelid, but they are more painful than those that appear on the lips, for example. We talked about methods for quickly treating herpes on the lips in the article.

There are clinical forms of ophthalmoherpes. Among them:

• eyelid dermatitis;
• keratitis (the cornea becomes inflamed and cloudy, the patient cannot open his eyes);
• stromal keratitis (vascular damage, displacement of the eyeball);
• trophic keratitis (cornea loses sensitivity);
• herpetic corneal ulcer;
• blepharoconjunctivitis (rash on the inside of the eyelids, along the edge and in the corner of the eye);
• herpetic uveitis (the vitreous body of the eye becomes cloudy);
• retinal necrosis (dangerous loss of vision).

There is also species classification of ocular herpes. Among the most common types:

Diagnostic methods

For an accurate diagnosis and selection of appropriate treatment for the disease, a visual examination, various tests (visometry - for visual acuity, perimetry - for the width of the visual field), laboratory methods, as well as psychosomatics - a technique for studying the impact of psychological factors on the patient's condition are used.

The main role is still given to laboratory methods using special equipment.

Slit lamp inspection

An examination using this device helps to determine the nature of the corneal lesion and detect symptoms typical of a herpes infection.

Immunofluorescence analysis (RIF)

Experts consider this type of diagnosis to be the most accurate. Material taken from an infected area is examined under a microscope.

After exposure to ultraviolet radiation, the sample gives (or does not give, then the diagnosis is not confirmed) a special glow.

Linked immunosorbent assay

The method is used in the most difficult cases when other studies and analyzes provide conflicting results.

The method is based on the fact that in case of ophthalmoherpes, immunoglobulins M must be present in samples taken from infected areas.

Depending on the form and severity of the disease, the doctor selects etiotropic and symptomatic therapy: the first is aimed at combating the causative agent of the disease, the second helps to get rid of unpleasant symptoms when the eyelids swell, become inflamed, and itch.

Drugs

A large group of antiviral drugs used to treat ophthalmoherpes includes:

• Acyclovir (tablets and ointment);
• Valacyclovir (tablets);
• Famvir (tablets);
• Oftan-IDU and TFT (eye drops);
• Vidarabine (gel).

The patient is prescribed immunomodulators made from donor blood and modifying cell membranes in such a way as to protect them from the penetration of the virus: Interlock, Reaferon, Cycloferon.

These drugs are used for injection, as well as in the form of tablets and eye drops.

Used to relieve symptoms of the disease Atropine, Irifrin– they relieve spasms that often accompany eye infections.

Opatanol drops help with allergic reactions. For burning and itching, you can apply tetracycline or erythromycin ointments to the areas of inflammation.

If healing of wounds takes a long time and causes pain, the doctor prescribes physical treatment (UV, UHF).

Let's start with a taboo: on some forums on the Internet, garlic is recommended as a cure for ocular herpes, but in no case should it be used to treat sores on the eye or even under the eye.

The body's reaction to such a radical remedy can be unpredictably severe.

But what traditional medicines do professional doctors approve of?:

Any folk remedy is only a help, and not the main medicine, but they must be used to alleviate the patient’s condition.

Vaccine use

Vaccines are used in cases where the patient suffers from relapses of the disease. Domestic drugs are most often used "Gerpovax" and "Vitagerpevac", as well as the Belgian "Gerpevac".

Vaccination is carried out when the patient's exacerbation period ends. It is allowed to repeat it no earlier than after 6 months.

Antiherpetic interferon has a vaccine-like effect on the body (it is produced in the form of an ointment). It blocks the activity of the virus and prevents it from reaching healthy cells of the body.

Many people are interested in whether pets (for example, kittens) can have herpes and how to protect their health. It turns out that the problem of herpes also affects our smaller brothers, and the infection selects the smallest, weakest animals.

Fortunately, vaccination is also provided for them - in the clinic it will be carried out by a veterinarian for pets from 3 months to 3 years.

The causes of the development of the disease are almost the same in children and adults, but the symptoms are somewhat different, which means that the treatment required is different.

In addition to the classic symptoms of ophthalmoherpes, a child develops a cold sore on the lips.

This, on the one hand, makes it possible to quickly make an accurate diagnosis, and on the other, complicates treatment. Therefore, trying to cope with the disease without medical support is strictly prohibited.

But you can provide first aid to your baby before going to the doctor: drop Ophthalmoferon drops into the sore eye.

By the way, ocular herpes often occurs in children who are being treated for chickenpox. Parents need to keep this in mind and monitor the condition of their baby's eyes.

The most dangerous complications occur in cases where herpes is localized not near the eye, but directly in its tissues. This may cause:

This development of events can be expected if the patient did not attach due importance to the disease, tried to self-medicate at home, and the method he chose turned out to be insufficiently developed for this disease and is not supported by official medicine (for example, homeopathy).

Prevention

Any type of virus (herpes zoster, ocular) is dangerous for relapses, so the doctor prescribes it to recovered patients antiviral drugs as prophylaxis.

They help avoid frequent re-outbreaks, but they cannot completely defeat the disease.

• reduce close contacts with the sick person to a minimum, since the virus is contagious;
• use only your own hygiene items;
• do not overheat in the sun and do not overcool the body in winter;
• eat right, not forgetting about vitamins;
• improve health (hardening and physical therapy will help).

Ophthalmoherpes is the most dangerous form of manifestation of the herpes virus in the human body. The fact is that by affecting the cornea of ​​the eye, it can lead to rapid deterioration of vision. If you do not consult a doctor in time, it can penetrate into the deep tissues of the organ of vision, and this can lead to loss of vision.

Near the child's eye

In general, our eyes are well protected from the effects of viral infections. The tear that is constantly released from the eye contains a sufficient amount of secretory immunoglobulins of class A, mucosal cells, which, at the slightest attack by pathogens, begin to actively produce interferon, blocking their further spread.

So in what cases does herpes develop on the mucous membrane of the eye?

• First of all, infection occurs during a decrease in the level of the body’s defense – immunity.
• Mechanical damage to any part of the visual organ.
• Pregnancy, when a woman’s body is weakened ().
• After taking immunosuppressants.
• Subsequently suffered stress.
• Hypothermia and colds.
• During overheating in the sun.
• Hormonal disorders and changes in the body.
• Past vaccinations, including.

Initially, you can become infected with the herpes virus on the eye through contact with a carrier of the disease and through the use of his things, since the virus enters the body through the mucous membrane of the oral cavity or subsequently through sexual contact. There is also a chance of contracting the disease through sharing dishes, towels or personal hygiene products.

There are two routes of infection:

1. Endogenous. The herpes virus in the eye enters the epithelium, multiplies and quickly spreads throughout the body using the circulatory and lymphatic systems. Once in the nerve endings and nodes, it remains there for the rest of its life, dormant and waiting in the wings.
2. Exogenous. Herpetic blisters immediately affect the mucous membrane of the organ of vision. This route of infection is especially common in children. Newborns can “receive” the virus by passing through the birth canal of the mother, who.

It is worth mentioning that the disease is caused by two viruses. The first is the smallpox virus, which affects the eye. Another virus causes herpes under the eye, affecting the cornea.

What happens when the eyes become infected?

When the herpes virus enters the eye and its tissues, it begins to multiply rapidly, affecting the upper layer of the cornea. Having accumulated in sufficient quantities in keratocytes, the disease begins to damage the membrane. Having destroyed it, it comes out, infecting all the cells in the neighborhood. The latter, together with adjacent tissues, die and begin to peel off. Possible autoimmune infection.

Clinical symptoms.

Expressed in:

• The eyeball and eyelid are too red.
• Profuse lacrimation.
• Sharp and sharp pain in the eyes and head.
• Feeling of a foreign body and pain.
• Objects are seen in a distorted form and a veil appears.

Ophthalmic herpes, the symptoms of which depend on the clinical form, is typical:

1. With herpetic dermatitis of the eyelids, there is redness, bubbles with liquid appear, the skin burns, and the temperature rises.
2. With herpetic conjunctivitis, a rash appears and the eyes turn red.
3. With herpetic keratitis, the level of sensitivity of the cornea decreases, there is a fear of light, excessive production of tears, and bubbles with liquid form on the nerve fibers of the cornea.
4. With stromal keratitis, the vascular tract is affected, the iris increases in size, intraocular pressure is increased, the eye disc is displaced.
5. With a herpetic corneal ulcer, there is no sharp pain.
6. With herpetic uveitis, the vitreous body becomes cloudy, precipitates occupy a central location, and a “blind spot” may appear.
7. In acute retinal necrosis, there is a possibility of losing vision as a result of inflammatory processes in the eye.
8. With postherpetic trophic keratitis, the cornea of ​​the eye thickens, the sensitivity of the cornea is completely absent, and vision rapidly decreases.
9. With herpes in children, the conjunctiva swells and a herpes rash is visible at the edges of the eye.

Diagnostics.

When suffering from ophthalmic herpes, inflammatory processes in both adults and children have the same symptoms. This allows you to quickly identify them and begin treatment. To accurately diagnose the disease it is necessary:

• Inspect the skin of the eyelids, where a herpetic rash can be detected.
• Check your vision, as during a viral infection it worsens significantly.
• Take a test to determine your vision limit.
• Check corneal sensitivity. Often it is absent or reduced to a minimum.
• Examine the anterior and posterior parts of the eyeball.
• Examine the fundus to identify other infectious diseases.

These laboratory tests are required, since sometimes it is very difficult to determine the infection by eye. Along with this, it is necessary to undergo tests such as:

1. A scraping from the eye membrane to determine the presence of antibodies to the virus.
2. A general blood test to determine the level of leukocytes and lymphocytes.
3. A smear from the membrane of the eye and cornea. This test detects the DNA virus.

Complications of ophthalmoherpes.

Keratitis - caused by ophthalmoherpes

Of particular danger to our body are the complications that can develop after ocular herpes. There are two forms of complications:

1. Specific. This form of complication is caused by incorrect and neglected treatment. The viral infection, having overcome tissue barriers, enters the blood and lymph. This leads to damage to internal organs. It can often be confused with a chronic disease. Ocular herpes can lead to rapid deterioration of vision or its complete loss, clouding of the cornea and increased pressure inside the organ of vision. Often accompanied by headache.
2. Non-specific. It is characterized by the addition of a foreign infection of a viral or bacterial type. Promotes the development of nerve atrophy, retinal detachment, inflammation of the veins of the eye, and nerve neuritis.

Treatment and medications.

Treatment of herpes on the eye depends on the clinical form of the disease and is prescribed strictly on the recommendation of an ophthalmologist. Therapeutic treatment involves the use of measures to prevent the reproduction of an infectious virus and its further spread. It is applied until external manifestations completely disappear.

The most are:

1. Acyclovir.
2. Valaciclovir.
3. Cidofovir.

OFTAN-DIU has excellent antiviral properties, which eliminates infection and its manifestations. In order to relieve inflammation of the eyeball and remove rashes on the eyelid, drops such as Okoferon and Miramistin, Okomistin and Indocollir are used.

Effective results from physiotherapy. You can fight the disease with the help of medicinal electrophoresis using atropine, hydrocartisone and aloe extract. Thanks to its deep penetration, rapid healing of eye tissue occurs.

In addition to medications, you can additionally use:

• Means to strengthen the immune system.
• Antipyretic and painkillers.
• Iodine. They apply it to the rash. It dries it well and speeds up the crust formation process.
• Compresses. They do a great job with itching. Prescribed on the recommendation of a specialist. Particularly suitable for children.

Some people rely on traditional medicine. However, remember that it cannot replace the full treatment of ophthalmoherpes with medications. Its role is rather auxiliary and is aimed at reducing pain, as well as speedy healing of wounds. Before using herbal infusions, make sure that you are not allergic to some of the components.

The most common are infusions of lungwort, vitamin teas and decoctions of arnica flowers. Their dried extracts are diluted with hot water and used as lotions and compresses. Teas are accordingly taken orally.

Prevention.

Recommendations from the company Cycloferon.

To prevent the disease you need to follow some simple rules:

1. First of all, wash your hands thoroughly with soap and water before touching your eyes.
2. If you wear contact lenses, then during the infection with the herpes virus, give them up altogether.
3. Do not try to peel off the bubbles when a crust forms on them.
4. Engage in increasing the protective function of the body - immunity. Try to lead a healthy lifestyle - eat well, exercise in accordance with your age and health status, and sleep at least 9 hours a day.
5. Try to limit communication with people who are potential carriers of the virus.
6. Do not use other people's cosmetics.
7. Do not abuse fizzy drinks - they provoke inflammation of ophthalmoherpes with their composition.
8. Eat more foods that contain lysine.

Thus, ophthalmoherpes, although not a very common disease, is quite complex. After all, it affects the main and only organ of vision – the eyes. Having identified the first symptoms of the disease, you need to consult with a specialist in order to prevent its complications and spread to other vital organs.

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• And now you are ready to take advantage of any opportunity that will help you get rid of herpes!

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Herpes for the eyes is a dangerous disease because... The virus attacks the cornea and causes vision impairment.

In weakened patients, ophthalmoherpes gives up to 5 relapses per year. In advanced cases, the deep tissues of the eye suffer and diseases develop leading to complete loss of vision.

Causes of ocular herpes

The causative agents of herpes on the eye are several strains:

• Herpes simplex virus (type 1).
• Chickenpox virus is a strain of Varicella zoster.
• HSV-2 – .
• Cytomegalovirus.

In a healthy person, the organs of vision are well protected from pathogenic agents. Tear fluid contains A-class immunoglobulins, which produce their own interferons and prevent the spread of the virus.

In a carrier of a herpes infection, specific killer T cells circulate in the blood, purposefully working to defeat harmful viruses.

A person gets ophthalmoherpes for various reasons:

Primary infection with herpesvirus occurs through contact with a sick person or through the use of common household items. The virus enters a healthy body through the respiratory and genital tract, as well as through the mucous tissues of the oral cavity.

Having initially penetrated the epithelial tissue, the virus gradually moves into the circulatory and lymphatic systems and takes root in the nerve branches. There he remains in a dormant state until circumstances favorable for activation occur.

In children, eye infection with herpes is associated with increased mobility, poor hygiene and staying in groups. The development of ophthalmoherpes in a newborn is caused by the passage of a mother infected with herpes through the infected birth canal.

Clinical picture of ophthalmoherpes

In adults and children, the symptoms of ocular herpes are the same:

• Tearing in the absence of emotions.
• Redness of the eyeball.
• Narrowing of the palpebral fissure.
• Decreased visual acuity.
• Deterioration of vision at dusk.
• Irritation and pain from light.
• Blepharospasm is convulsive twitching of the eyelids.
• Distortion of the shapes and sizes of visible objects.
• Headaches, weakness, slight increase in body temperature.
• The skin of the eyelids becomes overgrown with small bubbles with dirty yellow contents.

With herpetic neuritis of the optic nerve, patients complain of pain in the orbit and brow ridge, discomfort when rotating the eyeball and a sensation of a blind spot in its center.

Signs of ocular herpes also include thickening of the skin above the eye, itching, tingling and redness of the eyelid. Several days pass after the watery blisters appear. Then they burst, and the bare places become overgrown with crusts. The scab completely falls off after 2 weeks.

Ophthalmoherpes is diagnosed in one of the following forms:

• Acute retinal necrosis - inflamed lesions on the surface of the eyeball, poor vision.
• Conjunctivitis is a true inflammation of the visual organ.
• Herpetic dermatitis of the eyelids is itching, burning and redness of the skin of the eyelids, followed by the formation and self-opening of liquid elements.
• Keratitis is an inflammation of the cornea with clouding, photophobia and the inability to open the eye.
• Herpetic corneal ulcer is an ulceration of the cornea without pain symptoms.
• Blepharoconjunctivitis is an inflammation of the eye and eyelid with the formation of a rash on the inside of the eyelid and along the edge of the eye.
• Stromal keratitis - hyperemia of the iris, herpetic damage to the ocular vessels, increased intraocular pressure, decreased sensitivity of the cornea, displacement of the apple.
• Keratoiridocyclitis is an inflammatory disease of the first branch of the triangular nerve. If left untreated, this form is dangerous due to the appearance of eyesores and loss of vision.
• Postherpetic trophic keratitis - the cornea thickens and loses sensitivity. Bubbles appear on the eye, vision decreases significantly.
• Herpetic uveitis - the disease is manifested by clouding of the vitreous glass and the formation of small bubbles in the center.

You can see what eyes look like with ophthalmoherpes in the photo.

Diagnosis and treatment of ocular herpes

You can find out how to treat herpes on the eye from an ophthalmologist. To clarify the diagnosis, the doctor examines the patient using a slit lamp.

The study helps to track changes in the cornea and inflammatory processes occurring in local vessels. In addition, the specialist takes a scraping of cells from the affected skin or mucous membrane and submits the material for study under a fluorescent microscope.

A blood test for suspected ophthalmic herpes is carried out in the form of an enzyme immunoassay. Based on his answers, the doctor checks whether the patient’s body has antibodies to the virus.

The listed methods are applicable only for cases of damage to the ocular cornea or blood vessels. Damage to the skin of the eyelids and mucous membranes of the delicate visual organs is observed visually and does not require additional examination.

Video:

Drug therapy

What medications exist to treat herpes on the eyelid or eyeball? Doctors develop a course of therapy by choosing drugs from 4 groups - immunomodulatory, symptomatic, antiviral and specific in the form of an antiherpetic vaccine.

Typically, antiviral drugs with a gentle effect on the mucous membranes of the visual system are used to treat ophthalmoherpes. These are ointments, drops and tablets:

• Acyclovir – tablets for oral administration and ointment for external treatment.
• Zovirax - the active substance of acyclovir ointment is quickly absorbed by the corneal epithelium and periocular tissues. The diseased eye collects such a concentration of medication that can suppress the virus.
• Vidarabine - a gel for treating the conjunctiva is used during treatment 5 times a day.
• Tebrofen, Riodoxol, Bonafton - ointments are placed behind the eyelid or applied to the skin of the eyelids.

Ophthalmologists prescribe the following eye drops for eye herpes: Oftan-IDU, Trifluorothymidine, Idoxuridine. The drugs contain an analogue of thymine, a substance that prevents the pathogen from multiplying. To increase the effectiveness of therapy, it is recommended to use drops every hour. But the course of treatment should not be overestimated, since liquid medications can harm the cornea.

Oftalmoferon drops for the treatment of ocular herpes are sealed in a dropper bottle. They contain interferon alpha-2a and diphenhydramine. Drops relieve inflammation, fight pathogens, accelerate healing of the affected eye and strengthen the immune system.

In the acute stage of herpes, Oftalmoferon is injected into the affected eye up to 8 times a day, 1 to 2 drops per session. As the inflammatory process subsides, the number of manipulations is reduced to 2–3 times a day. Treatment is carried out until the symptoms disappear completely.

If the herpes virus affects the deep structures of the eye, the patient is offered surgical intervention. Coagulation and keratoplasty allow you to completely remove the affected areas or localize them.

Video:

Traditional methods of treatment

When diagnosed with ocular herpes, treatment with folk remedies is allowed in addition to drug therapy. For eye lotions and compresses, experts recommend preparing the following herbal remedies:

One of the most dangerous manifestations of herpes infection in the human body is ophthalmoherpes or herpes in the eyes. Most often, herpes viruses cause lesions of the cornea - keratitis, which often cause rapid deterioration of vision.

According to modern data, the proportion of herpesvirus diseases of the cornea in some countries is more than 80%. Ophthalmoherpes can give from 3 to 5 relapses per year. If left untreated, the infection process involves the deeper tissues of the eye, which often leads to disability and sometimes complete loss of vision.

Pathogens of ophthalmoherpes

The main causative agents of herpes that affects eye tissue are the herpes simplex virus type 1 - Herpes simplex virus-1 (HSV-1) and the varicella zoster virus - Varicella zoster. In recent years, evidence has emerged of the increasing role of herpes simplex virus type 2, cytomegalovirus, and HSV-6 in ocular lesions, which commonly cause genital herpes, infectious mononucleosis, and roseola infantile, respectively.

All members of the herpesvirus family are spherical in shape. At the center of the viral particle is a double-stranded DNA molecule formed by strands of different lengths.

The genetic material of herpes viruses is protected by three shells. DNA is tightly packed into a layer of protein molecules of the same size, forming a regular twenty-sided structure - a capsid. Outside of it is an amorphous protein layer called the tegument. The third shell (supercapsid) is a phospholipid membrane.

Penetrating a cell, the virus integrates its DNA into its genome and uses the host’s protein-synthesizing apparatus to produce viral components. The formation of new virus particles occurs on the inner nuclear membrane of cells. The pathogen accumulates in large quantities in the nucleus, breaks its membrane and leaves the cell. When leaving the nucleus, viral particles capture part of its membrane, acquiring a supercapsid.

Ways of eye virus infection

Normally, the eye is quite reliably protected from viral infections: the tear fluid contains secretory immunoglobulins of class A, the cells of the mucous membrane, in response to the introduction of viruses, produce interferons that prevent the spread of the pathogen. With a latent herpes virus infection, activated killer T cells also constantly circulate in the blood, capable of purposefully destroying cells affected by the virus.

The development of ophthalmoherpes is possible only against the background of a decrease in the reactivity of the immune system, which occurs as a result of previous infectious diseases, severe stress, prolonged exposure to the sun, and hypothermia. Activation of the virus can also result from eye injury, pregnancy, or treatment with immunosuppressants, cytostatics, and prostaglandin drugs.

Initial infection with herpes viruses occurs through the mucous membranes of the mouth, respiratory or genital tract through direct contact with a sick person, using shared utensils, towels, toys, and hygiene items.

The virus multiplies in epithelial tissue, then penetrates the circulatory and lymphatic systems, dispersing throughout the body. HSV-1, HSV-2 and Varicella zoster migrate to the nerve ganglia, where they remain latent throughout life. Most often, the cause of ophthalmoherpes is precisely these “dormant” viruses. This route of infection is called endogenous.

However, exogenous infection of the mucous membrane of the eye is also possible when the contents of vesicles formed as a result of herpes on the lips or chicken pox get on it.

Exogenous infection occurs especially often in preschool children due to their increased physical activity, presence in organized groups and low level of hygiene. The proportion of exogenous herpetic eye lesions in this age group can reach 80%. Exogenous infection of newborns during passage through the birth canal of a mother suffering from genital herpes is also possible.

Pathogenesis of the disease

Upon exogenous or endogenous penetration into the eye, the virus begins to multiply in the surface layer of the cornea. The pathogen accumulates in keratocytes, ruptures the membrane and comes out, infecting neighboring cells. The release of the virus is accompanied by the death and desquamation of corneal cells and other tissues involved in the infectious process.

In addition to mechanical defects, viral replication causes autoimmune lesions. Since the supercapsid of herpes viruses is formed by the nuclear membrane of affected cells, it carries on its surface antigens - protein molecules characteristic of the human body. On the one hand, this partially masks the virus from the effects of the immune system, allowing it to spread throughout the body. On the other hand, antibodies produced in response to the introduction of a virus can destroy a person’s own cells, mistakenly recognizing them as foreign.

Symptoms and clinical picture of ophthalmoherpes

Some symptoms of ophthalmoherpes are similar to those with eye lesions of an allergic and bacterial nature. These include redness of the eyelids and eyeball, watery eyes and photophobia, pain and a sensation of a foreign body in the eye.

With herpetic lesions of the retina, various forms of keratitis, in addition to the indicated signs, the following are also observed:

• decreased visual acuity or blurred vision;
• flashes and sparks before the eyes;
• distortion of the shape and size of objects;
• double vision;
• twilight vision impairment.

Often there is a convulsive closure of the eyelids - blepharospasm.

With herpetic neuritis of the optic nerve, severe pain in the orbit and brow ridge, a narrowing of the field of vision or a blind spot in its center, pain when moving the eyes, and a feeling of a veil before the eyes are observed. Possible nausea, headache, increased body temperature.

Clinical forms

With primary infection with herpes viruses, ophthalmoherpes occurs quite rarely. More than 90% of cases are eye lesions that occur during recurrent infections. In this case, tissue damage can be superficial or deep and affect only the anterior part of the eye (sclera, conjunctiva, cornea), or the anterior and posterior (choroid, retina, optic nerve) parts.

The table below shows the clinical forms of ophthalmoherpes:

Anterior lesions	Posterior lesions
Superficial	Retinochoroiditis (formation of a cloudy white lesion in the retina)
Conjunctivitis	Chorioretinitis (inflammation of the posterior choroid)
Blepharoconjunctivitis (inflammation of the conjunctiva and eyelids)	Uveitis (inflammation of the choroid)
keratitis (corneal lesion) vesicular (formation of blisters on the cornea followed by ulceration) tree-like (fusion of ulcers to form branched lines) geographic (larger ulcers than with tree-like ones, have jagged edges) marginal (ulceration of the edges of the cornea).	Inflammation of the optic nerve (neuritis)
Corneal erosion	Perivasculitis (superficial inflammation of blood vessels)
Episcleritis (inflammation of the connective tissue between the sclera and conjunctiva)	Acute retinal necrosis syndrome (rapid death of the retina with severe inflammation of the choroid)
Deep	Central serous retinopathy (macular detachment)
Metaherpetic keratitis (damage to large areas of corneal stroma)	Anterior ischemic retinopathy (stagnation of blood in the retina)
Deep keratitis without ulceration focal (accumulation of fluid in the cornea with scattered foci of opacification) discoid (accumulation of fluid in the center of the cornea in the form of a disk) bullous (swelling and clouding of the cornea) interstitial (swelling of the deep layers of the cornea)

Approaches to diagnosing the disease

Inflammatory eye diseases of various natures often have similar symptoms, which do not allow their cause to be clearly determined.

The basis for diagnosing ophthalmoherpes is a set of characteristic symptoms, taking into account infectious diseases and other provoking factors in the anamnesis, as well as assessing the improvement of the patient’s condition during treatment with antiherpetic drugs.

An examination with a slit lamp is mandatory, which often reveals corneal lesions typical of herpesvirus infection: single or tree-like ulcerations, foci of opacification, vascular inflammation and venous stagnation.

The most accurate diagnostic method is the immunofluorescence reaction (RIF), or the fluorescent antibody method (MFA). The essence of the method is to treat scrapings of cells of the affected tissue with antibodies to the herpes virus labeled with fluorochrome. Smears are prepared from the resulting material and examined under a fluorescent microscope.

An ultraviolet lamp is used as an illuminator in such a microscope; when irradiated, the fluorochrome emits a green or orange glow. If the cause of the disease is herpes viruses, their antigens are located on the membranes of the affected cells, with which labeled antibodies react. If the result is positive, luminous cells are detected in the smears.

In severe or doubtful cases, antibodies to the virus are determined by enzyme immunoassay. The herpetic nature of eye lesions is indicated by the presence of immunoglobulins M, low-avidity IgG, or a fourfold increase in IgG titer during two examinations with an interval of 14-21 days.

The research method is determined by the stage and form of the disease. It must be remembered that contacting a doctor in the early stages of infection will avoid not only complications, but also invasive methods of collecting material.

What are the possible complications?

With superficial localization of the infectious process and timely treatment, ophthalmoherpes, as a rule, goes away without consequences.

When the deep structures of the eye are involved, a decrease in visual acuity is often observed due to clouding of the cornea and vitreous body, and corneal blindness may occur.

Long-term herpetic eye infection in some cases leads to cataracts and glaucoma. Retinal lesions are often accompanied by hemorrhages or necrotization (death), which can result in partial or complete detachment with irreversible loss of vision.

Treatment

The treatment regimen for ophthalmoherpes depends on the clinical form of the disease. For superficial lesions, specific (etiotropic) and symptomatic therapy is limited. The first is aimed at suppressing the activity of the pathogen, the second is aimed at alleviating the symptoms of the disease (swelling, pain, lacrimation, impaired blood supply and trophism).

The main importance for successful treatment is the direct effect on the herpes virus. To do this, three approaches are used:

• the use of antiviral drugs (usually acyclovir and its derivatives);
• nonspecific immunotherapy (interferon inducers, immunoglobulin preparations);
• specific immunotherapy (herpetic vaccine, antiherpetic immunoglobulin).

The maximum effect is achieved by the combined use of drugs with different mechanisms of action. This approach allows for rapid elimination of symptoms and a reduction in the frequency of relapses.

If the deep structures of the eye are affected, in addition to drug treatment, they resort to surgical intervention (microdiathermocoagulation, keratoplasty, neurotomy, laser coagulation). These methods are aimed at eliminating or limiting the lesion.

Symptomatic therapy includes the use of vitamin, anticonvulsant, decongestant, analgesic and absorbent drugs, which are most often administered by drip, by electro- or phonophoresis.

Drugs for the treatment of ophthalmoherpes

Etiotropic therapy for herpes eye lesions is carried out locally using ointments and drops, as well as systemically in tablet and injection forms of drugs. The most common means of targeting herpes viruses include:

• Oftan IDU is one of the first drugs for the treatment of herpetic eye lesions. In terms of chemical structure, it is an analogue of the nitrogenous base thymine, which is part of DNA. Due to the similarity of structure, it blocks the enzymes responsible for the incorporation of thymine into nucleic acids and suppresses the replication of the virus. Available in the form of drops for topical use;
• Trifluorothymidine (TFT) is an analogue of Oftan IDU with a similar mechanism of action, but less toxic and better soluble in water, which facilitates administration. Used in the form of eye drops;
• Vidarabine (Ara-A) is a structural analogue of adenine that blocks the formation of viral nucleic acids. Available as a 3% ointment;
• Acyclovir for herpes in the eyes is prescribed orally in tablet form and topically as an ointment (Zovirax, Virolex). The mechanism of action of the drug is also associated with inhibition of enzymes involved in DNA synthesis due to the structural similarity of the active substance to guanosine;
• Valtrex (Valacyclovir) is an acyclovir derivative with a similar effect against herpes viruses. It is administered orally in tablet form. Valacyclovir is an inactive form of acyclovir, which is converted in the human body to acyclovir;
• Florenal, tebrofen, bonaftone, riodoxol are synthetic antiviral agents for topical use in the form of an ointment. When treating ophthalmoherpes, put it behind the eyelids and apply to the affected skin around the eyes.

Nonspecific immunocorrection is carried out with immunoglobulin preparations and interferonogenesis inducers.

Immunoglobulin preparations include interferon α, interlock, reaferon.

Interferon α and interlock are a mixture of human leukocyte interferons obtained from donor blood. The antiviral effect is associated with modification of the membranes of healthy cells, preventing the penetration of the virus. Both drugs are used in the form of drops.

Reaferon is a recombinant interferon synthesized by bacterial cells with an introduced human interferon genome. The mechanism of action is similar to that of Reaferon and Interlock. It is administered dropwise directly into the eye, or in the form of periocular injections.

The most popular interferon inducers are pyrogenal, poludanum, thymalin, tactivin, levamisole, lycopid, sodium nucleinate, amixin, cycloferon. These drugs are prescribed both systemically (in tablet and injection forms) and locally in the form of periocular injections.

The introduction of inducers leads to the activation of interferon synthesis by the body's own cells. This reduces the risk of side effects, since the use of donor and recombinant interferons can cause allergic reactions.

Specific immunocorrection is carried out using a herpetic vaccine or antiherpetic interferon.

The vaccine is a mixture of inactivated herpes viruses types 1 and 2. In the pharmacy chain, the vaccine is represented by the drugs Vitagerpavak (Russia), Gerpovax (Russia), Gerpevac (Belgium). The vaccine is administered intradermally every six months between relapses of the disease.

Antiherpetic interferon (Gerpferon) is a combination drug in the form of an ointment for topical use. Contains two active components - recombinant interferon and acyclovir at a concentration of 3%. The combination of these components provides an effect on the pathogen and protects healthy cells from its penetration.

For deep eye lesions, in addition to the listed groups of drugs, mydriatics, antiseptics and antibiotics, and antiallergic drugs are administered.

The use of mydriatics is necessary to reduce spasm of the ciliary muscle and photophobia. Such drugs include Atropine, Midriacil, Cyclomed, Irifrin.

A common complication of severe ophthalmoherpes is the addition of bacterial infections. For their treatment and prevention (during surgery), antibiotics and antiseptics are prescribed in the form of drops or ointments.

The most commonly used injections are cephalosporins (ceftriaxone) and fluoroquinolones (ciprofloxacin); ofloxacin, tobramycin, lomefloxacin in the form of drops; ointments based on tetracycline and erythromycin. The choice of drug is made on the basis of bacteriological examination.

The need to use a complex set of drugs often leads to allergic reactions. To prevent them, antihistamines are prescribed - Lecrolin, Tavegil, Suprastin, Diphenhydramine.

For optic neuritis, drugs are additionally prescribed that improve blood supply and tissue nutrition - nicotinic acid, pentoxifylline, vitamins B, A, PP and C.

To eliminate opacities, dionin, lidase, vitreous preparations, aloe, calcium chloride, amidopyrine, etc. are used. The action of these drugs is aimed at resolving infiltrates and restoring damaged tissues.

Prevention of eye infection with the herpes virus

The main set of preventive measures is aimed at interrupting the routes of transmission of the pathogen: avoiding direct contact with a sick person, using individual dishes, towels, cosmetics, and carefully observing personal hygiene rules in the presence of other forms of herpes.

Pregnant women infected with genital herpes are prescribed treatment and undergo thorough treatment of the birth canal to avoid infecting the child during childbirth.

For recurrent herpes, vaccination with an antiherpetic vaccine and administration of immunomodulatory drugs are carried out under mandatory medical supervision. Additionally, the diet is adjusted, multivitamin preparations, physical exercise and hardening procedures are prescribed as a means of increasing immunity.

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