Herpetic Keratitis
What is Herpetic Keratitis?
Herpetic keratitis is a viral eye infection that affects the cornea. The cornea is the clear, dome-shaped surface that covers the front of your eye. This condition is caused by the herpes simplex virus, most commonly HSV-1. This is the same virus that causes cold sores on the mouth.
When the herpes virus infects the cornea, it can cause inflammation and painful sores. The infection can affect the outer layer of the cornea or go deeper into the tissue. Repeated infections can lead to scarring of the cornea. This scarring can blur vision and, in severe cases, cause permanent vision loss or blindness.
Herpetic keratitis is one of the most common causes of corneal infections in the United States. Early detection and treatment are important to prevent serious damage to your eyes. Blood testing can help confirm if you have been exposed to the herpes simplex virus.
Symptoms
- Eye pain that can range from mild to severe
- Redness and irritation in the affected eye
- Blurred or cloudy vision
- Watery discharge from the eye
- Sensitivity to light
- Feeling like something is stuck in your eye
- Swelling around the eye
- Small sores or ulcers on the cornea
Some people may have mild symptoms at first and not realize they have an eye infection. Early symptoms can feel similar to pink eye or dry eyes. If you experience persistent eye pain, vision changes, or light sensitivity, see an eye doctor right away.
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Causes and risk factors
Herpetic keratitis is caused by the herpes simplex virus, usually type 1. Most people are exposed to HSV-1 during childhood through contact with saliva or skin. The virus then stays dormant in nerve cells near your eyes and face. When the virus reactivates, it can travel to the cornea and cause an infection. You can also get herpetic keratitis from HSV-2, the type usually linked to genital herpes, though this is less common.
Risk factors include a weakened immune system, stress, fever, sun exposure, eye injury, and certain medications like steroids. People who get frequent cold sores may be at higher risk. Wearing contact lenses while infected can worsen the condition. The virus can also spread from touching a cold sore and then touching your eye. Once you have had one episode, the infection can come back multiple times throughout your life.
How it's diagnosed
An eye doctor will examine your eyes using a special microscope called a slit lamp. They may apply a yellow dye called fluorescein to your eye to highlight any corneal damage. The pattern of the infection often looks like a tree branch, which is a classic sign of herpetic keratitis. Your doctor may also swab the eye to test for the virus directly.
Blood tests can help confirm if you have been exposed to the herpes simplex virus. Rite Aid offers HSV-1 IgG antibody testing as an add-on to our flagship health panel. Elevated levels of HSV-1 IgG antibodies suggest a past or present infection. This information helps your doctor understand your risk and guide treatment decisions. Visit a Quest Diagnostics location to get tested.
Treatment options
- Antiviral eye drops or ointments to stop the virus from spreading
- Oral antiviral medications like acyclovir or valacyclovir for more serious infections
- Avoiding steroid eye drops unless prescribed by a specialist, as they can make the infection worse
- Removing contact lenses until the infection clears completely
- Using artificial tears to keep the eye moist and comfortable
- Managing stress through sleep, nutrition, and relaxation techniques
- Protecting your eyes from UV light with sunglasses
- Washing hands frequently and avoiding touching your eyes
- Seeing an eye specialist if you have recurring infections or vision changes
Need testing for Herpetic Keratitis? Add it to your panel.
- Simple blood draw at your nearest lab
- Results in days, not weeks
- Share results with your doctor
Frequently asked questions
Herpetic keratitis is caused by the herpes simplex virus, usually type 1. This is the same virus that causes cold sores. The virus stays dormant in your nerves and can reactivate to infect the cornea. Triggers include stress, illness, sun exposure, and a weakened immune system.
Yes, herpetic keratitis can cause blindness if left untreated or if infections happen repeatedly. The virus can scar the cornea, which clouds your vision. Deep infections can damage the cornea permanently. Early treatment with antiviral medications can prevent serious vision loss.
Herpetic keratitis often causes more severe eye pain than pink eye. You may also notice light sensitivity and blurred vision. An eye doctor can tell the difference by examining your cornea with a special microscope. The infection often creates a distinctive branching pattern on the cornea that is visible with fluorescent dye.
Blood tests can show if you have been exposed to the herpes simplex virus by detecting HSV-1 IgG antibodies. However, they cannot confirm an active eye infection. Your eye doctor will examine your cornea directly to diagnose herpetic keratitis. Blood tests help understand your overall risk and infection history.
The herpes virus itself is contagious, but you cannot spread the eye infection directly to someone else's eye. You can spread the virus through contact with saliva or sores. Avoid touching your eyes after touching a cold sore. Wash your hands frequently and do not share towels or eye makeup.
With antiviral treatment, most cases improve within 1 to 2 weeks. Mild infections of the outer cornea usually heal faster. Deeper infections may take several weeks or longer to resolve. Your eye doctor will monitor your progress and adjust treatment as needed.
No, you should not wear contact lenses during an active infection. Contact lenses can trap the virus against your cornea and make the infection worse. They also slow healing and increase the risk of scarring. Wait until your eye doctor confirms the infection has fully cleared before wearing contacts again.
Yes, herpetic keratitis can recur because the virus stays dormant in your nerves. About one in three people will have another episode within 2 years. Your doctor may prescribe long-term antiviral medication to prevent recurrences. Managing stress, protecting your eyes from UV light, and supporting your immune system can also help reduce the risk.
Foods high in lysine, like fish, chicken, and legumes, may help suppress the herpes virus. Avoid foods high in arginine, like nuts and chocolate, which can trigger outbreaks. Some studies suggest vitamin C, zinc, and probiotics may support immune health. Always talk to your doctor before starting new supplements.
See an eye doctor right away if you have severe eye pain, sudden vision changes, or sensitivity to light. Do not wait if you notice discharge, cloudy vision, or feel like something is in your eye. Early treatment prevents serious damage. If you have a history of cold sores and develop eye symptoms, seek care promptly.