What does ocular herpes look like? Eye herpes. Necrotizing stromal herpetic keratitis - video

Herpes for the eyes is a dangerous disease, because. the virus infects the cornea and contributes to the deterioration of vision.

In debilitated patients, ophthalmic herpes 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 eye herpes

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

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

In a healthy person, the organs of vision are well protected from disease-causing agents. The 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 T-killer cells circulate in the blood, purposefully working to defeat harmful viruses.

A person becomes ill with ophthalmic herpes 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.

Initially, having penetrated into the epithelial tissue, the virus gradually moves into the circulatory and lymphatic systems and takes root in the nerve branches. There he stays in a sleeping state until the onset of circumstances favorable for activation.

In children, infection of the eye with herpes is associated with increased mobility, poor hygiene and being in groups. The development of ophthalmic herpes in a newborn is due to the passage of a mother infected with herpes through an infected birth canal.

Clinical picture of ophthalmic herpes

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

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

With herpetic neuritis of the optic nerve, patients complain of pain in the orbit and superciliary arch, discomfort during the rotation of the eyeball and a feeling 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. After the appearance of watery bubbles, several days pass. Then they burst, and the bare places are overgrown with crusts. The scab completely falls off after 2 weeks.

Ophthalmic herpes is diagnosed in one of the 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 - 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 its clouding, photophobia and inability to open the eye.
• Herpetic corneal ulcer - ulceration of the cornea without pain symptoms.
• Blepharoconjunctivitis is an inflammation of the eye and eyelid with a rash on the inside of the eyelid and along the edge of the eye.
• Stromal keratitis - hyperemia of the iris, herpetic lesions of the eye vessels, increased intraocular pressure, decreased sensitivity of the cornea, displacement of the apple.
• Keratoiridocyclitis is an inflammatory disease of the first branch of the trigeminal nerve. If left untreated, this form is dangerous with the appearance of a walleye and loss of vision.
• Postherpetic trophic keratitis - the cornea thickens and loses sensitivity. Bubbles appear on the eye, vision drops significantly.
• Herpetic uveitis - the disease is manifested by clouding of the vitreous glass and the formation of small bubbles in the center.

How the eyes look with ophthalmic herpes, you can see in the photo.

Diagnosis and treatment of eye herpes

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

The study helps to track changes in the cornea and inflammatory processes occurring in local vessels. In addition, a specialist takes a scraping of cells from the affected skin or mucous membrane and transfers the material for examination 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 looks to see if the patient has antibodies to the virus.

The listed methods are applicable only for cases of damage to the 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 need additional examination.

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Medical therapy

What drugs are available for the treatment of herpes on the eyelid of the eye or on the eyeball? Doctors develop a course of therapy by choosing means from 4 groups - immunomodulatory, symptomatic, antiviral and specific in the form of an antiherpetic vaccine.

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

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

Ophthalmologists prescribe eye drops for eye herpes as follows: Oftan-IDU, Trifluorothymidine, Idoxuridin. The preparations contain an analogue of thymine - a substance that prevents the pathogen from multiplying. To increase the effectiveness of therapy, drops are recommended to be used every hour. But you should not overestimate the course of treatment, since liquid medicines can harm the cornea.

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

In the acute stage of herpes, Oftalmoferon is injected into the diseased eye up to 8 times a day, 1-2 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 deep structures of the eye are affected by the herpes virus, the patient is offered surgical intervention. Coagulation and keratoplasty allow you to completely remove the affected areas or localize them.

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Folk methods of treatment

With the diagnosis of 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:

Health problems associated with occur in 90% of people.

The rash appears all over the body, including the eyes.

In the event that bubbles appear above the eye, emergency measures must be taken, since ophthalmic herpes is considered one of the serious forms of the disease that can significantly impair vision.

In 85% of recorded calls, the presence of an inflammatory process on the cornea is noted - in this case, a diagnosis is made. can be repeated up to 5 times a year, so it is important to follow the recommendations. If the disease is not treated for a long time, the inflammatory process penetrates into the deep eye tissues, which can lead to loss of vision.

causative agents of infection

Complications and prevention

You need to know what is different. Herpes can appear after or overheating in the sun.

An untreated cold can also start the process. Reduced immunity and eye injuries are common factors leading to the disease. Symptoms of the infection are common, but there are also rashes near the eyelids or above the lip.

Itching and lacrimation worse than in adults. Treatment should be - ointment, suppositories and drops according to age.

If treatment is not carried out or interrupted, complications may occur. These include a drop in visual acuity and clarity, the appearance of pain, especially when looking at a bright light. Sometimes there is total blindness.

As an effective preventive measure, special means are used to prevent the development of infection, as well as general measures to strengthen the body's immunity, since it is he who is the main factor in preventing the activation of the herpes virus.

Hardening and moderate physical activity work effectively.

Herpes on the human body can manifest itself in different ways. The most dangerous option is herpes in the eyes. Ophthalmic herpes is not dangerous in itself, its consequences are much worse - keratitis, that is corneal injury leading to impaired vision and even blindness. It is the herpes virus that is the most common cause of keratitis, especially if it is recurrent. Without proper treatment, herpes affects more and more tissues of the eye, which means that loss of vision becomes inevitable.

Causes of ophthalmic herpes

Most often Herpes simplex virus is the cause of herpes eye or herpes virus zoster(chickenpox), although the herpes virus can cause eye infections 2 types(genital), cytomegalovirus and herpes virus 6 types(causing roseola). All of these types of virus are embedded in the cells of the body, where the formation of new viral particles occurs.

The note

The virus enters the body through the mucous membrane of the mouth, respiratory organs or sexually. You can get herpes by sharing a dish or towel with a sick person. First, the virus lives in the epithelial tissue, then moves into the blood and lymph, thanks to which it spreads throughout the body.

For the time being, the body resists viruses, as it is protected by immunity. If the virus enters the mucous membrane of the eye, then the interferon produced by the mucous membrane prevents it from spreading. Also, the tissues of the eye are protected by immunoglobulins contained in the lacrimal fluid. The virus that causes herpes in the eyes can “sleep” in the nerve nodes for a very long time.

If, for some reason, immunity decreases, the herpes virus strengthens and manifests itself in the form of ophthalmic herpes. Reduced immunity occurs as a result of the following situations:

• hypothermia;
• prolonged exposure to the sun;
• infectious diseases;
• stress;
• eye injury;
• the use of certain drugs (immunosuppressants, cytostatics, etc.);
• pregnancy.

The virus “sleeping” up to this point “wakes up” and comes to the surface in the form of characteristic bubbles. This type of disease is called endogenous. The exogenous route is when infection occurs directly through the herpes vesicles - the liquid from them, containing viruses in high concentration, enters the mucous membrane of the eyes, as a result of which infection with ophthalmoherpes occurs. This path is especially characteristic for children who play together and can infect each other by direct contact.

Herpes on the eyes - symptoms

Eye herpes can be confused with allergies or diseases caused by bacteria ( conjunctivitis, blepharitis, or bacterial keratitis). All inflammatory eye diseases - including herpes - are accompanied by the following symptoms:

• soreness;
• distortion and impaired visual acuity, especially at dusk;
• photophobia;
• lacrimation.

Local symptoms can be supplemented by general ones - headache, nausea, swollen lymph nodes and fever.

Specific symptoms of herpes in the eyes, by which it can be distinguished from other diseases:

• severe burning and itching of the skin on the eyelids and around the eyes;
• the appearance of bubbles with liquid inside, which then burst and ulcerate.

Forms of herpes

Ophthalmic herpes differs from other types of herpes in a large number of manifestations, and the symptoms during relapses can be very different. Depending on the damage to the tissues of the eye, the following main forms of herpes in the eyes are distinguished:

How to identify herpes

The symptoms of a cold eye, as herpes is often called, are similar to those of other diseases. Makes an accurate diagnosis ophthalmologist who performs a slit-lamp examination, which reveals ulceration and other lesions of the cornea, as well as inflammation of the eye vessels. Also in hospital scraping of cells from the affected mucosa or skin is performed which is examined using a fluorescent microscope.

The note

Another diagnostic method is enzyme immunoassay, which can detect the presence of antibodies to the virus.

The listed diagnostic methods are required for damage to the cornea and blood vessels. As a rule, herpetic lesions of the mucous membrane of the eyes and skin of the eyelids are noticeable even without a medical examination. Herpes on the eyelid is characterized by multiple rashes in the form of small vesicles with lymph - a liquid that gradually becomes cloudy. The blisters hurt and itch a lot. If you scratch the sore, it spreads even more.

What is dangerous herpes in the eyes

If herpes is localized on the surface, then adequate treatment allows you to get rid of it without negative consequences. If deeper tissues are affected, then the following consequences are possible:

• clouding of the cornea;
• decreased visual acuity;
• retinal hemorrhages;
• retinal detachment (complete or partial);
• cataract;
• glaucoma;
• death of the retina;
• complete loss of vision.

Serious problems with vision arise, of course, not from primary herpes, but if it is not treated, it will recur, each time affecting the deeper structures of the eye, which will lead to irreversible consequences.

Herpes on the eye of a child

In childhood, risk factors for the manifestation of herpes in the eyes are hypothermia, overheating, excessive exposure to the sun, stress, hormonal changes in the body, vaccinations, eye microtrauma. Children often ophthalmic herpes is accompanied by herpetic eruptions on the lips. In addition to the appearance of bubbles on the eyelids and lips, you need to pay attention to the following symptoms:

• redness of the eye;
• lacrimation;
• itching of the eyelids;
• Pain in the eyes;
• feeling of sand in the eyes.

All these symptoms indicate the development of herpes in the eyes. In this case, you should immediately consult a doctor. As a first aid before a doctor's appointment, you can use Oftalmoferon drops to relieve discomfort and suppress the activity of the virus.

Attention

Self-medication for herpes in children is absolutely impossible to do! Incorrectly selected therapy or lack of treatment will lead to serious problems up to loss of vision.

Particular attention should be paid to the prevention of herpes in front of a child. To do this, you need to lead a healthy lifestyle, observe the daily routine, get enough sleep, do not overcool and do not overwork. It is worth taking vitamins seasonally, especially special eye complexes containing blueberry extract are especially useful.

Treatment of herpes in the eyes

How to treat a cold on the eye? It depends on the form of the disease. If only superficial tissues are affected, there will be enough drugs to relieve discomfort and to suppress the activity of the virus.

There are four types of drugs that are used to treat herpes in the eyes in combination:

• antiviral;
• immunomodulatory agents;
• specific immunopreparations (herpes vaccine);
• symptomatic remedies: vitamins, painkillers, decongestants, etc.

If the deep tissues of the eye are affected, only surgery can help: coagulation(thermo or laser), keratoplasty and other types of operations that will localize or remove the affected tissue.

Antiviral agents for the treatment of herpes in the eyes

The mucous membrane of the eye is different from the skin, therefore, for applying drugs to it, forms are used that do not irritate the mucous membrane. To suppress the activity of the herpes virus, eye ointments and drops are used, as well as tablets and injections.

The most effective drugs for the treatment of herpes in the eyes:

• Acyclovir- with this form of the disease, it is taken orally in the form of tablets (0.2 grams up to 5 times a day), and the ointment is also applied topically. You can use Zovirax or Virolex;
• Valaciclovir- for the treatment of ophthalmic herpes, only tablets are used, for example, Valtrex 0.5 grams twice a day. Once in the human body, valacyclovir turns into acyclovir, which is most active against the herpes virus;
• Oftan-IDU (idoxuridin, keracin, etc.)- This is a special drug for the treatment of herpes in the eyes. Available in the form of drops containing an analogue of thymine. The drug prevents the virus from multiplying and suppresses its activity. Drops are instilled often - every hour. With prolonged use, the drug can lead to damage to the cornea;
• TFT (trifluorothymidine)- one more drops, similar to Oftan-IDU, but having a less toxic effect;
• Vidarabine- gel against eye herpes, which is applied to the conjunctiva up to five times a day;
• Tebrofen, riodoxol, bonafton- ointments against herpes, they are applied to the skin of the eyelids affected by herpes, and laid behind the eyelids.

Immune drugs in the treatment of ophthalmic herpes

Herpes is a sign of reduced immunity, which is why, with herpetic eruptions, immunocorrection is carried out, for which interferon and immunoglobulin preparations are used.

Immunoglobulins for non-specific therapy for herpes - interlock and interferon-alpha, as well as reaferon:

1. Interlock and interferon-alpha- These are drugs in the form of drops based on donor blood, which contain human leukocyte interferons. They modify cell membranes, so that the virus does not penetrate into them.
2. Reaferon- a synthetic preparation of a bacterial nature containing human interferon. Means in the form of drops for instillation into the eye. It can also be injected into the area around the eye.

In addition to immunoglobulin preparations, interferon inducers are used:

• half-dan;
• levamisole;
• amiksin;
• licopid;
• cycloferon;
• thymalin.

These drugs can be taken as tablets, as well as injections, in some cases injections are given periocular, that is directly into the eye. Thanks to the intake of these drugs, the production of its own interferon by the human body increases. And if taking immunoglobulins can cause allergies, then interferon inducers have practically no side effects.

herpes vaccine

A herpes vaccine has been developed from inactivated herpes simplex and herpes type 2 viruses. The vaccine is administered for recurrent ophthalmic herpes strictly in the period without exacerbation of the disease, you can repeat the introduction of the vaccine no earlier than six months later. Vaccines on the market from different manufacturers, the most famous of which are Russian-made Vitagerpevac and Gerpovax, as well as Belgian-made Gerpevac.

Also, for specific immunocorrection in case of herpes in the eyes, antiherpetic interferon is used in the form of an ointment, which is applied topically. Gerpferon consists from recombinant interferon and 3% acyclovir Thus, the drug blocks the action of the virus and protects healthy cells from it.

Concomitant medicines

Herpetic eye infection is often accompanied by pain and spasms. Used to relieve spasms mydriatics (Atropine, Irifrin and others). Also, in case of serious damage to the tissues of the eye, they are prescribed antiseptics and antibiotics.

Often bacterial infections are added to herpes. To treat this complication, antiseptics and antibiotics are used. Most effective for treating co-infections cephalosporins and fluoroquinolones. Antibiotics are injected or in the form of drops, tetracycline and erythromycin ointment are also used.

Attention!

Antibiotics should not be taken without a doctor's prescription and bacteriological examination!

Herpetic eye damage - especially complex - is treated with a large number of drugs, which can cause an allergic reaction. To warn her, usually prescribe antihistamines such as Suprastin, Tavegil etc.

For a speedy recovery, vitamin preparations, as well as agents that enhance the supply of blood to the eye. These are nicotinic acid, vitamins A, C, group B, pentoxifylline.

Folk remedies

The mucous membrane of the eye is a very delicate tissue., which is undesirable to be affected by irritating substances. efficient folk remedy for the treatment of herpes in the eyes is garlic juice but I can't recommend it to everyone. The individual reaction of the eye can be unpredictable.

It is better to use softer means:

• infusion of marshmallow flowers - for washing the eyes, the infusion is prepared from 2 tablespoons of dried flowers, brewed with a glass of boiling water;
• honey with water in a ratio of 1 to 2 - instill in the eyes;
• a compress of fresh dill juice relieves inflammation;
• gruel from grated fresh potatoes - such a lotion relieves pain and burning;
• infusion of rosehip berries - used for washing the eyes and compresses, relieves inflammation and pain;
• aloe juice diluted with water (1:10) is instilled into the eye and used for compresses.

It should be borne in mind that folk remedies are designed to alleviate the condition of the patient, but they do not cure the disease. They cannot resist the virus. Therefore, it is impossible to use only folk remedies.

Prevention of herpes in the eyes

Herpes in the eyes is dangerous for its frequent relapses. Therefore, it is important not to let the virus spread..

To prevent herpes from being transmitted to other people, it is important:

• observe personal hygiene,
• use individual dishes and towels,
• avoid direct contact with the patient.

The note

A person prone to manifestations of herpes in the eyes should lead a healthy lifestyle, avoid hypothermia or overheating in the sun, and not overwork.

To strengthen the immune system, and hence for the prevention of herpes, walks in the fresh air and physical education, hardening, proper nutrition and taking multivitamins are useful. At the first manifestations of herpes in the eyes, you should consult a doctor and choose an adequate therapy in order to prevent the development of the herpes virus in the body and complex eye lesions.

It can affect all organs and systems, including the eyes. The most common diseases are herpes zoster, skin lesions of the eyelids, conjunctivitis, keratitis, inflammation of the choroid (iridocyclitis and chorioretinitis), optic neuritis, herpetic retinopathy, acute retinal necrosis. All these diseases are in the vast majority of cases chronic and often lead to complications.

Causes of herpetic eye damage

According to the time of occurrence, herpes is acquired and congenital. Herpes is caused by virus types 1, 2 and Varicella Zoster. Predisposing factors:

hypothermia
- stress
- concomitant severe diseases that contribute to a decrease in immunity, including infectious
- immunodeficiency
- malnutrition
- long-term use of antibiotics

Herpes infection is a highly contagious disease. Ways of transmission: airborne, contact, sexual, ascending (from other organs), transplacental.

Herpes zoster with manifestations in the eyes occurs when the first branch of the trigeminal nerve is involved in the inflammatory process. At first, pains on the affected side, malaise, body temperature may rise. Then bubbles with transparent contents appear on the reddened skin, then it becomes cloudy, and crusts form, which can leave scars.

The skin of the upper eyelid and the eyebrow area is affected, rarely the lower eyelid (with damage to the 2nd branch of the nerve). Regional lymph nodes enlarge and become painful. If the nervus nasociliaris is involved in the process, then characteristic rashes appear at the inner corner of the eye and on the cornea. Almost always, the virus affects one half of the face.

With herpes of the skin of the eyelids, severe itching and burning are noted, bubbles appear on the hyperemic (reddened) skin, their contents become cloudy, then crusts form. When they are combed, scars remain.

There are 3 forms of herpetic conjunctivitis: follicular, catarrhal and vesicular-ulcerative.

First type has a sluggish course, characterized by mild reddening of the eyes and poor mucous discharge. There are no typical symptoms.

At catarrhal form complaints are more pronounced, has an acute course.

Classic manifestations vesicular herpetic conjunctivitis- rashes in the form of bubbles, the formation of crusts without scarring.

Keratitis, caused by the herpes virus, is divided into tree-like, marginal, corneal erosion, discoid, bullous, metaherpetic. The symptoms of all kinds are similar. Characterized by blepharospasm (impossible to open eyes), photophobia and lacrimation, pain. The sensitivity of the cornea is reduced, which can lead to accidental injury and secondary infection. Eruptions and infiltrates appear on the cornea. The most pathognomonic herpetic keratitis is dendritic. In this case, bubbles appear along the nerve fibers of the cornea. Bursting, they cause pain.

Discoid keratitis is deep. There is a rounded clouding of the corneal stroma. The appearance of folds of the Descemet's membrane and precipitates on the endothelium is possible. Often passes into iridocyclitis. The prognosis is unfavorable, because. corneal opacities often remain.

Deep keratitis refers to keratouveitis. In these cases, the symptoms of iridocyclitis join the symptoms of inflammation of the cornea.

Iridocyclitis, caused by the herpes virus, can occur in an acute, subacute and sluggish form. By the nature of the process is serous and serous-fibrinous. Characterized by pain in acute and subacute course, pericorneal injection of the conjunctiva, sebaceous precipitates on the endothelium of the cornea, moisture of the anterior chamber opalescent (if secondary flora joins, then hypopyon), hyphema is possible (erythrocytes in the moisture of the anterior chamber), posterior synechia (the pupil does not expand or has irregular shape), the formation of adhesions between the iris and the lens or in the angle of the anterior chamber (intraocular pressure increases accordingly). The iris becomes full-blooded, edematous, its pattern is smoothed.

Acute retinal necrosis- one of the types of chorioretinitis, a possible cause is the herpes virus. It occurs more often in people with immunodeficiency (for example, HIV-infected). Symptoms: loss of vision if the central region is involved in the process. First one eye is affected, and after a few months the second. Inflammatory foci appear, first on the periphery, then they merge, and this can lead to exudative retinal detachment. Perhaps the appearance of infiltration in the vitreous body. Later, strands may form, leading to tractional retinal detachment. More than half of people who have acute retinal necrosis go blind.

Other eye diseases do not have specific manifestations of herpes infection. The presence of the virus is detected only during the examination.

Diagnosis of the herpes virus

To make a diagnosis, you need:

On external examination, there may be characteristic rashes on the face and eyelid skin,
- visometry - vision can be sharply reduced in the presence of corneal infiltrate, chorioretinitis or optic neuritis,
- perimetry,
- analgysemetry - with herpetic infection, the sensitivity of the cornea is reduced,
- biomicroscopy, including after staining with fluorescein,
- inspection in transmitted light to determine the transparency of the media of the eye,
- ophthalmoscopy, as well as examination with a Goldman lens to identify foci of infection in the fundus.

In most cases, the symptoms are not specific to herpes, so a diagnosis cannot be made without laboratory confirmation. One of the diagnostic methods is the determination of antibodies to the virus in a scraping from the conjunctiva using the method of fluorescent antibodies. In the general blood test, the level of leukocytes and lymphocytes is increased (if there is an immunodeficiency, then it is reduced), with a primary infection, intradermal allergic tests are performed. Examine the state of the immune status for the correct appointment of immunomodulators. In smears-prints from the cornea and conjunctiva, PCR can detect virus DNA.

The most reliable diagnostic method is virology (the virus is grown on chicken embryos or special nutrient media), but it is very expensive and lengthy (up to 3 weeks), therefore it is used more often for scientific purposes, and not for prescribing treatment.

Also determine the antibodies to herpes in the blood. An elevated IgG level indicates a previous infection. If IgM is detected, then the process is acute. They appear on the 5th-7th day of the disease, so it does not make sense to test for antibodies earlier (for example, ELISA - enzyme immunoassay).

Mandatory consultations of a dermatovenereologist, infectious disease specialist, neuropathologist.

Eye herpes treatment

Treatment must be carried out under the supervision of an ophthalmologist. If the skin of the face and eyelids is affected, the bubbles are smeared with acyclovir ointment 3% 4 times a day for up to 2 weeks. To dry the inflammatory elements, it is possible to use dyes locally (brilliant green solution, iodine solution, fucorcin).

Oftan-IDU is instilled into the conjunctival sac 4 times a day for 10 days to prevent the spread of infection.

With herpes zoster and severe pain, novocaine blockades are made, and antiherpetic drugs are taken orally for a week (Acyclovir 5 times a day, 0.2 grams, Valaciclovir, 0.5 grams 2 times a day). To accelerate healing, physiotherapeutic methods of treatment (UHF, UFO) are locally used.

With herpetic conjunctivitis, the following drugs are prescribed:

Antiviral drops and ointments - Oftan-IDU 1 drop 6 times a day, Okoferon 1 drop 6 times a day, Acyclovir ointment 3% 2-3 times a day
- antiseptic drops - Miramistin, Okomistin 1 drop 6 times a day
- anti-inflammatory drops - Indocollir, Naklof, Diklof 1 drop 3 times a day
- antibacterial drops when secondary bacterial flora is attached (Floxal, Tobrex, Oftakviks 1 drop up to 6 times a day)
- antihistamine drops - sodium cromoglycate or Opatanol 1 drop 3 times a day when an allergic reaction occurs.

Long-term treatment, at least 3-4 weeks under the supervision of an ophthalmologist.

Complications of herpes in the eyes:

spread of infection (keratitis), allergic reactions.

Herpetic keratitis is the most common viral infection affecting the eyes. Treatment is complex and is carried out in a hospital. Approximate treatment regimen: instill into the affected eye 6 times a day, 1 drop of Oftan-IDU, Okoferon, Okomistin, Floksal; 3 times a day Indocollir and Acyclovir ointment 3%. With deep keratitis, mydriatics are prescribed to prevent the occurrence of synechia (Tropicamide, Midriacil 2-3 times a day). If the corneal epithelium is not damaged, then hormonal drops and ointments are used (hydrocortisone ointment 1%, dexamethasone drops 0.1% 2-3 times a day). Some drugs are best administered subconjunctival or parabulbarno, for example, interferon, mezaton, dexamethasone, antibiotics. Local treatment is combined with general therapy: antiviral (Acyclovir 0.2 grams 5 times a day), vitamin therapy (ascorbic acid, B vitamins). Interferon production inductors are also shown, for example, Cycloferon according to the scheme or Amizon. If necessary, the immunologist prescribes immunomodulators. Physiotherapy accelerates the healing process: UHF, UVI, magnetotherapy, laser therapy, phonophoresis.

If conservative treatment is ineffective, laser coagulation or cryotherapy of inflammatory foci is used. Complications of keratitis: uveitis, allergic reactions, clouding of the cornea up to the walleye.

Treatment herpetic uveitis (iridocyclitis and chorioretinitis) requires intravenous infusion of acyclovir at a dosage of 5-10 mg / kg every 8 hours, intravitreal administration of valaciclovir or famciclovir is possible. In severe cases, with proliferative changes in the vitreous body and the risk of retinal detachment, surgical treatment is indicated - vitrectomy and laser coagulation of the affected areas of the retina. Complications: loss of vision, retinal detachment.

Prevention of herpes

Herpes affects 95% of the total population. The virus lives in the human body and may not manifest itself, but under adverse conditions, relapses of the disease occur. Therefore, prevention consists in strengthening immunity, timely and comprehensive treatment of exacerbations, good nutrition and a healthy lifestyle, and vaccination during remission.

Ophthalmologist Letyuk T.Z.

Why does herpes occur near the eye? The causes of this disease will be discussed below. We will also present the symptoms of ophthalmoherpes and drugs that treat this disease.

general information

Herpes (this pathology occurs infrequently on the eyelid) is a viral disease. It is characterized by eruption of vesicles (grouped) on the mucous membranes and skin.

The name of the term in question is of Greek origin. Translated into Russian, it means "creeping", or "rapidly spreading skin disease."

Description of the disease

The herpes virus in the eyes does not appear as often as, for example, on the lips, in the nasal mucosa or on the genitals. At the same time, such an ailment is very difficult.

In addition to the listed parts of the body, the herpes virus can affect the central nervous system, which will cause the development of meningitis and encephalitis. Internal organs are also affected by this disease.

Types of viruses

Herpes, which has arisen under the eye, belongs to the first type. Also, the herpes simplex virus can affect the lips, nose, and other skin areas.

In the second type of such a disease, the genital areas are affected.

Varicella zoster virus (3 types) is also distinguished. appears on the human body. As for such a childhood disease as chickenpox, it is observed throughout the body.

Epstein-Barr virus belongs to the fourth type. It causes an infectious disease called mononucleosis.

Cytomegalovirus is a type 5 disease.

Causes

Why does herpes occur on the eye (the treatment of this disease will be presented below)? There is a lot of controversy about this. It is not possible to name any one reason for the occurrence of such unpleasant rashes. This is because herpes can occur due to a number of different factors.

Experts say that the virus in question is present in the body of all people. And for the time being, the human immune system resists this disease. The virus, which has got on the mucous membrane of the eye, spreads very rarely. This is due to the fact that the visual organs are able to independently produce interferon, that is, proteins secreted by tissue cells in response to the invasion of harmful bacteria.

It should also be noted that the tissues of the eye are protected by the so-called immunoglobulins, which are contained in the lacrimal fluid. Herpes on the eyes, the symptoms of which will be described below, may not appear for a long time and "sleep" in the nerve nodes.

If for one reason or another the human immune system is noticeably weakened, then the herpes virus begins to actively strengthen and manifest itself in the form of ophthalmic herpes.

Thus, it can be safely noted that the main and main reason for the development of the disease in question is reduced immunity. In connection with the foregoing, the question arises of why the human immune system gives such failures? Doctors say that a decrease in the body's defenses occurs in response to the following situations:

If one of these factors contributes to a decrease in immunity, then the herpes virus, “dormant” up to this point, “wakes up”, and then comes to the surface of the skin or mucous membrane in the form of grouped bubbles.

It should be especially noted that this variant of the development of the disease is called endogenous. There is also an exogenous way. For him, infection is characteristic directly through herpetic vesicles. As you know, they contain liquid, which includes viruses in high concentrations. Once on the skin or mucous membrane of the eyes, an instant infection occurs.

This path is especially typical for young children who are constantly in contact with each other.

Signs of illness

How does herpes appear in front of the eyes? The symptoms of this disease are quite difficult to ignore. Although in some cases it is confused with an allergy or a disease that is of bacterial origin (for example, conjunctivitis, blepharitis or bacterial keratitis).

It should be noted that all of the listed pathological conditions, however, like ophthalmic herpes, are accompanied by the following symptoms:

• redness of the eyelid and eyes;
• photophobia;
• soreness;
• impaired visual acuity and distortion of vision;
• lacrimation.

It is impossible not to say that the local symptoms of a viral disease can be supplemented by general ones, including headache, swollen lymph nodes, nausea and fever.

Specific Symptoms

So how to identify herpes on the eye, the treatment of which should only be carried out by an experienced doctor? This disease also has specific symptoms. These include the following:

• unbearable itching and burning of the skin on the eyelids, as well as around the eyes;
• the presence of fluid-filled blisters that burst and ulcerate.

Forms of ophthalmic herpes

The disease in question is characterized by a huge number of manifestations. In this case, the symptoms of relapse can be quite different.

Experts distinguish the following forms of ocular herpes (depending on the damage to the tissues of the visual organs):

• With such a disease, the conjunctiva is affected, that is, a thin film of the epithelium that covers the inside of the eyelids and the eyeball. As a rule, this lesion is accompanied by redness of the entire eye.
• Keratitis. This is a disease characterized by damage to the cornea, on which viral vesicles appear.
• Blepharo-conjunctivitis. Unlike herpetic conjunctivitis, an inflammatory process is added to the lesion of the conjunctiva, as well as the formation of vesicles on the eyelids and along the eyelash growth line. Rashes can appear even on the inner surface of the eyelids. Usually, there is severe lacrimation, as well as sharp pains in the eye.
• Keratoiridocyclitis is an inflammation of the cornea, which is accompanied by damage to the vessels in the visual organ. This form of the disease is the most severe. It is very difficult to cure her. In this case, keratoiridocyclitis repeats again and again.

Diagnosis of the disease

How to cure herpes on the eye? Treatment of this disease should be prescribed by an ophthalmologist. However, the disease must first be correctly diagnosed. This is due to the fact that the symptoms of such a pathological condition are often confused with signs of other abnormalities.

For the diagnosis of ocular herpes, the patient must consult an ophthalmologist. The doctor is obliged to examine the patient using a slit lamp. Such a study allows you to identify ulcers and other lesions of the cornea, as well as inflammatory processes in the eye vessels.

Also in stationary conditions, cells are scraped from the affected skin or mucous membrane. It is further studied through

Another way to diagnose the disease in question is It allows you to identify the presence of antibodies to the virus in a person.

All of these diagnostic methods are used only in case of damage to the vessels and cornea of ​​the eye. As for the herpetic lesion of the mucous membrane of the visual organs and the skin of the eyelids, it is noticeable even without examination.

Herpes on the eyelids is characterized by rashes (usually multiple) in the form of small vesicles filled with lymph, that is, a liquid that becomes cloudy over time. These blisters are very painful and itchy. If you comb the rashes, they spread even more.

Ophthalmic herpes: treatment

How should ocular herpes be treated? According to experts, the type of therapy for such a disease depends on its form. If the virus has affected only superficial tissues, then drugs are used that relieve discomfort in the visual organs, as well as suppress the activity of herpes.

There are 4 types of medicines on the pharmaceutical market that are used for the complex treatment of ophthalmic herpes. These include the following:

• immunomodulatory agents;
• antiviral (for example, "Zovirax-ointment");
• specific immunopreparations (for example, a herpes vaccine);
• symptomatic remedies, including decongestants, painkillers, vitamins, etc.

In the event that the deeper tissues of the eye are affected by the virus, the patient undergoes surgical intervention. Such types of operations as coagulation, keratoplasty and others, allow you to localize or remove the affected areas.

Antivirals

How to eliminate herpes on the eye? Treatment of this disease is most often carried out. For this, special forms of drugs are used that are not able to irritate the mucous membrane of the visual organs.

To suppress the excessive activity of the herpes virus, doctors recommend the use of eye drops and ointments. Also, for systemic exposure, patients are often prescribed antiviral injections and tablets.

What drugs are most effective in the treatment of ophthalmic herpes? Specialists distinguish the following drugs:

• "Acyclovir". With eye damage, the medication in question is used in the form of oral tablets, as well as in the form of a local ointment.
• "Valacyclovir". For the treatment of eye herpes, this drug is used in the form of tablets.
• Zovirax is an antiviral eye ointment that is very effective against herpes simplex viruses. After its use, the active substance of the drug is immediately absorbed by the periocular tissues and corneal epithelium. As a result, the concentration of the drug is formed in the intraocular fluid, which is necessary for the active suppression of the virus.
• "Oftan-IDU", "Idoxuridin" - such funds are specifically designed for the treatment of ophthalmic herpes. They are produced in the form of drops that contain an analogue of thymine. The drug in question does not allow the virus to multiply, and also suppresses its activity. For best effectiveness, the drops must be instilled every hour. However, with prolonged use, they can cause damage to the cornea.
• "Trifluorothymidine" are drops similar to "Oftan-IDU". However, it should be noted that they have a less toxic effect.
• "Riodoxol", "Tebrofen", "Bonafton" - all of these drugs are in the form of an ointment. They can be applied to the skin of the eyelids, as well as laid inside the eye.
• Vidarabine is an effective gel against ophthalmic herpes. It is applied to the conjunctiva 5 times a day.

Eye drops "Ophthalmoferon": instructions

What antiviral drug is most effective in ocular herpes? Experts say that these are drops of "Ophthalmoferon". Their price is about 300 rubles, so almost everyone can buy such a tool.

The medication in question contains diphenhydramine and interferon alfa-2a. It is available in polymer dropper bottles, which are placed in cardboard boxes.

Antiviral drops from lacrimation "Ophthalmoferon" have a wide spectrum of action. In addition to anti-inflammatory properties, such a drug exhibits immunomodulatory, antimicrobial, local anesthetic and regenerating effects.

Under what indications is the medication in question prescribed to patients? According to the instructions, it is used for:

• adenovirus, ;
• hemorrhagic, adenovirus and herpetic conjunctivitis;
• hypertensive stromal keratitis without ulceration and with corneal ulceration;
• herpetic uveitis;
• herpetic and adenovirus keratoconjunctivitis;
• herpetic keratouveitis (without and with ulceration).

As for contraindications, they are practically absent from this remedy. It is impossible to use these drops only with individual intolerance to their components.

How should the medication "Ophthalmoferon" be used? The dosage of this topical medicine should be determined by an ophthalmologist. In the acute stage, it is instilled into the affected eye 1-2 drops up to 7-8 times a day. As soon as the inflammatory process begins to stop, the number of instillations is reduced to 2-3 times a day.

The course of treatment with this drug is determined by the doctor. As a rule, the use of the drug is continued until the symptoms of the disease disappear completely.

Prevention of eye herpes

The main set of preventive actions for ophthalmic herpes should be aimed at interrupting the transmission of the virus. Thus, a person is required to refuse close contact with the patient, do not use the same dishes, towels and cosmetics with him, and also carefully observe the rules of personal hygiene in the presence of other forms of herpes.

As for pregnant women infected with genital herpes, they are prescribed special treatment, and then intensive treatment of the birth canal is carried out in order to avoid infection of the baby during its passage through them.

If herpes occurs too often, then vaccination is carried out with a special anti-herpetic solution. Also, the patient is administered under close medical supervision.

To prevent the possible development of the virus, potential patients should definitely adjust their diet. In addition, during the cold season, they need to take multivitamin preparations. Also, the patient is shown physical education and hardening procedures that will increase immunity, and therefore prevent the appearance of rashes.