A Comprehensive Guide to Herpes Keratitis

Dinesh Patel
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Dr. Kaushal

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Herpes Keratitis

Herpes keratitis is an eye infection caused by the Herpes simplex Virus (HSV).

It mainly affects the cornea causing inflammation, eye redness, tearing, and in some rare cases, vision loss.

According to the WHO, over 3.7 billion people under 50 years have been infected with HSV at some point.

There is no cure for herpes; once the virus is in the body, you cannot eliminate it. 

However, if you develop Herpes keratitis, some treatments can help you with it.

Read this article to learn about Herpes keratitis, its symptoms, types, causes, and treatment.


Keratitis treatmentSource: siniehinaalona

As per WHO, Herpes simplex virus is a very common infection that often is asymptomatic. However, it can lead to a significant eye disease.

Here are some common symptoms of HSV keratitis that you may experience:

  • Pain
  • Redness
  • Rash
  • Blurred vision
  • Tearing
  • Discharge
  • Sensitivity to light

Types of Herpes Keratitis

Herpes keratitis is classified into three types, each with its own set of symptoms and characteristics:

Epithelial keratitis

This type of Herpes keratitis affects the cornea’s outer layer (epithelium).

Epithelial keratitis can cause symptoms such as redness, tearing, photophobia (light sensitivity), and the sensation of a foreign object in the eye.

It may also result in the formation of tiny, fluid-filled blisters on the surface of the cornea.

Stromal keratitis

As per a study, the prevalence of Stromal keratitis among HSV patients is more than 30%.

Stromal keratitis impacts the deeper layers of the cornea. It can cause more severe symptoms such as eye pain, blurred vision, and light sensitivity.

It can even lead to corneal scarring, impairing vision.

Endothelial keratitis

Endothelial keratitis affects the cornea’s innermost layer (the endothelium). 

It can cause eye redness, pain, blurred vision, swelling, and cloudiness of the cornea.

It is important to note that while these are the three main types of Herpes keratitis, some people may experience symptoms of multiple kinds.

Suppose you have any symptoms of Herpes keratitis. You should see an eye doctor immediately because prompt treatment can help prevent complications and preserve vision.

Causes of Herpes Keratitis

Herpes keratitis is a viral eye infection caused by the Herpes Simplex Virus (HSV). There are several potential causes of Herpes keratitis, including

Primary HSV infection

A primary HSV infection can cause Herpes keratitis, usually when a person is young or in their teens.

This first infection can cause fever, sore throat, swollen lymph nodes, and skin or mouth sores.

Reactivation of latent HSV infection

HSV can remain dormant in the body for years after the initial infection and reactivate at any time. 

This reactivation can be triggered by some factors, including stress, illness, hormonal changes, and exposure to ultraviolet (UV) light.

Direct transmission

Herpes keratitis can also occur through the direct spreading of the virus from one individual to another.

You can get infected through contact with infected saliva, tears, or other bodily fluids.


It occurs when the virus is transferred from one body part to another.

You can get HSV from the lips to the eyes.


Eye trauma, such as a scratch or a corneal abrasion, can also develop Herpes keratitis.


People with weakened immune systems are at an increased risk of developing this condition.

HIV/AIDS is associated with several ocular problems, including Herpes keratitis.


putting eye dropsSource: eternalcreative_from_Getty_Images
Putting Eyedrop

There are different treatment options available for HSV keratitis.

Check with your doctor before starting with any one of them. The appropriate treatment will depend on the severity and the type of HSV involved. 

Some of them are,

Antiviral medicines

Herpes keratitis can be treated with antiviral medications like Acyclovir, Valacyclovir, and Famciclovir. 

These medicines stop the herpes virus from replicating and spreading. They can be taken as pills or put on the skin or in the eyes.


Corticosteroids can reduce inflammation in the eye due to Herpes keratitis.

But they should be used carefully because they can weaken the immune system and worsen the infection.

Check with your doctor before taking any medication. Do not self-medicate to reduce the risk of side effects.


In severe cases of Herpes keratitis, the infected tissue may need to be removed through debridement.

This procedure helps eliminate the virus and keeps the cornea from worsening.

It involves the removal of infectious viruses and antigens that may induce herpetic keratitis. 

Corneal transplantation

A corneal transplant may be required if the infection causes significant damage to the cornea.

Epithelial keratitis caused by the herpes simplex virus can be treated effectively. 

Still, recurrences can scar the corneal stroma and make it harder to see. 

Various studies show that herpetic stromal keratitis is a common reason for corneal transplantation.

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Herpes keratitis is an infection of the eyes caused by the Herpes simplex virus (HSV).

It primarily affects the cornea, which can become inflamed, red, and teary. In rare cases, it can even cause vision loss.

Various factors can cause Herpes keratitis, such as eye trauma, immunodeficiency, and autoinoculation.

The virus can lay dormant and be triggered due to stress and hormonal imbalance. It can also be due to exposure to UV rays.

Get in touch with your doctor, as this condition can be treated. Various medicines and procedures can help you fight HSV.

Frequently Asked Questions

How do you get Herpes Simplex Keratitis?

The Herpes Simplex virus is only found in humans and can lead to Herpes Simplex Keratitis. You can get it through direct contact, eye trauma, and immunodeficiency. The virus can lay dormant for some time and then become active.

How to treat Herpes Keratitis?

The treatment for Herpes Keratitis includes topical and oral medicines. Your doctor can prescribe antiviral or corticosteroid medications. Some severe cases may also need a corneal transplant.

How do you diagnose Herpes Simplex Keratitis?

HSV Keratitis is usually diagnosed as per the patient’s health history and what an eye exam shows. Lab testing is not typically necessary, but specific tests may further help confirm HSV.

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