Herpetic keratitis: causes and treatment

Development mechanism

Primary herpes infection can begin in the period from 5 months from birth to 5 years. The disease is manifested by tearing and photophobia. The cornea becomes cloudy, the iris is inflamed, swelling is noticeable. Perhaps the addition of other infections that worsen the course of herpetic keratitis.

In adulthood, post-primary keratitis may occur. Pathology has different forms, it is possible that the disease will pass without pronounced symptomatology, for example, only point and surface opacities appear. But it happens very rarely. Basically, the clinical picture is clear: the virus affects the inner layers of the cornea, there are extensive ulcerative lesions, up to the formation of a rough wall sickle.

Herpetic keratitis post-primary has a recurrent nature. After treatment, a re-reaction occurs under the influence of provoking factors. Due to weakened immunity, the symptoms each time become harder, the course of the disease is longer and the patient loses an increasing percentage of his vision.

herpetic keratitis treatment

Provoking factors

Most often, the disease appears on the background of infectious diseases and allergic reactions.

  • Wearing lenses and corneal injuries can activate the herpes virus in the body.
  • Not in the last place is professional activity: after the appearance of photokeratitis, welders are likely to develop herpetic keratitis of the eye.
  • Constant lack of vitamins in the body and as a result weakened immunity.
  • Against the background of an innervation disorder, if one branch of the trigeminal nerve is damaged, pathology may also appear.
  • Wearing contact lenses does not affect the cornea of ​​the eye in the best way and can also cause the appearance of the disease.


In general, for all forms, common symptoms of herpetic keratitis are distinguished:

  • blepharospasm;
  • fear of the light;
  • copious discharge of tears.

A neglected disease can lead to corneal clouding and a decrease in transparency and shine, and the sensitivity of the eye is lost. Lack of treatment can cause the development of cataracts, optic neuritis and glaucoma.

Clinical manifestations are divided into two types: superficial and stromal form.

herpetic keratitis of the eye

Surface manifestation of the disease

The patient's condition is characterized by vesicular corneal lesions. It is characterized by photophobia, foreign body sensation inside the eye. On the surface of the cornea are formed small bubbles, which quickly burst and form an erosive surface. After treatment, the appearance of microtubules is possible, whose effect on vision completely depends on the site of localization.

This form of pathology can manifest itself in the form of tree herpetic keratitis. The disease begins with vesicular lesions, then vesicular rashes join and form a pattern that looks like tree branches. In the diagnosis, bubbles and thickenings at the ends of such “branches” are clearly visible. The sensitivity of the cornea in the areas of injury is significantly reduced. The acute form becomes sluggish, which can last up to 5 weeks.

In many case histories, herpetic keratitis is interpreted as land cartoid, that is, transferred from a tree into a large superficial ulcer. Inflammation is characterized by jagged edges and may be the result of complications after steroid therapy.

The regional form of keratitis is very similar to the bacterial type of the disease, both in symptoms and in the causes of appearance.

treelike herpetic keratitis

Deep or stromal form

It is characterized not only by damage to the cornea, but also by involvement of the iris and ciliary body of the eye into the inflammatory process. All forms of pathology is very difficult, in addition, relapses often appear. As a rule, the virus penetrates from the posterior corneal epithelium into the stroma. The entire front section of the eye is usually covered with inflammation and there is a big risk of the second eye being affected by the virus.

The stromal form can manifest itself in the form of metaperpetic keratitis, which is first characterized by tree-like inflammation and the rapid transition of infection to the deep layers of the stroma. The inflammatory process can last more than 3 months.

Disc shape is characterized by the appearance of a source of infection in the center of the cornea, which can thicken more than 2 times. This condition complicates the diagnosis of the state of the pupil. Discoid lesion of the eye may appear on the background of other diseases, with tuberculosis or syphilis. In this case, diagnostic measures are inextricably linked with the identification of other pathologies in the body.

The deep diffuse form of the clinic is very similar to the discoid form. The main difference is that with diffuse keratitis, the inflammatory infiltration of the cornea does not have a clear and round shape.

herpetic keratitis photo

Diagnostic measures

Herpetic keratitis is fairly easy to diagnose, but not at home. Diagnosis is based on bacteriological and serological studies. The cornea of ​​the eye is examined under a slit lamp, scrapings from the conjunctiva are collected, and intraocular pressure is measured.

Photos of herpetic keratitis give a complete picture of the complexity of the disease and possible serious consequences for the patient, so any changes in the eye area should be a reason for prompt treatment to a medical institution for diagnosis and treatment.

herpetic keratitis eye treatment

Keratitis treatment

To date, there are two tactics of treatment of herpetic keratitis:

  • Conservative therapy, including the use of immunomodulators and antiviral drugs. In this case, you can not self-medicate, especially corticosteroids, which can cause blockage of the glands and cause an exacerbation of the disease.
  • Surgical intervention. This method of treatment is rarely used and depends entirely on the severity of the disease. The operation can be very simple and can even be done on an outpatient basis, but a cornea transplant can be indicated.

Tree keratitis is fairly well amenable to conservative treatment, but the therapy is long. The main thing is not to overdo it in this form of the disease - the dynamics of improvement will appear gradually, but in the end you can achieve a sustainable result.

Carotid keratitis is considered a sign of previous treatment failure. That is, there is a recurrence.

The most difficult treatment is disc-shaped herpetic keratitis. Most often it is associated with wearing lenses.

In the treatment of children, therapy should be complex, since corneal lesions often occur on the background of dysbacteriosis. Naturally, the lack of treatment of the underlying disease can not give positive results when keratitis.

Cross-linking can be used as an alternative treatment. This procedure can be used in the early stages of pathology.Based on the simultaneous instillation of special preparations and the effects of the Seiler lamp. The procedure is performed once and under local drip anesthesia. After treatment, soft contact lenses are worn to shorten the recovery period. Before the procedure, antiviral therapy is required. It should be noted that cross-linking has not yet been sufficiently studied and its effectiveness has not been fully proven.

In order to consolidate the results achieved in the treatment of herpetic keratitis of the eye and the acceleration of resorption of scars on the cornea, magnetic therapy and electrophoresis can be recommended.

In some cases, treatment of keratitis is possible with the help of cryotherapy, cauterization of the foci of inflammation with alternating current and laser coagulation.

Diet therapy is prescribed as concomitant treatment for patients. When keratite is not recommended fatty foods, it is necessary to limit the consumption of carbohydrates. In the diet will need to include vitamins and minerals, eat more high protein foods.

case history herpetic keratitis

Possible complications

Lack of treatment for keratitis can lead to many problems, in particular:

  • perforation of the cornea;
  • purulent damage to the vitreous body of the eye;
  • secondary glaucoma;
  • sclerite.

These diseases, in turn, increase the risk of eye loss or cause corneal clouding, which clearly reduces visual acuity.


The herpes virus is an infection that is completely impossible to get rid of, and if an inflammatory process occurs once, then the person is at risk. As a precautionary measure, you can be vaccinated before the onset of cold weather, since the virus is activated precisely with a decrease in atmospheric temperature.

Do not forget about personal hygiene, strictly follow all the recommendations of manufacturers of contact lenses for their wearing and care. Do not allow foreign bodies to enter the eyes. In no case should keratitis be treated with the help of folk remedies - the herpes virus cannot be treated with alternative medicine methods.

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