Materiały źródłowe

• #1 Herpes Simplex Ophthalmicus – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK559194/

  Herpes simplex ophthalmicus is an eye infection by the herpes simplex type 1 and type 2 viruses. […] Early diagnosis and treatment are keys to preventing complications. […] Oral antiviral prophylaxis of pregnant women at 36 weeks and opting for elective cesarean delivery prevents neonatal spread during birth. […] Long term oral antiviral prophylaxis prevents recurrences in corneal graft and stromal keratitis and keratouveitis. […] Long term oral antiviral prophylaxis prevents recurrences in corneal graft following penetrating keratoplasty for uncontrolled epithelial keratitis or for dense stromal scar secondary to HSV keratitis.

• #2 How to Manage Ocular Herpes

  https://www.reviewofophthalmology.com/article/how-to-manage-ocular-herpes

  Herpes simplex and herpes zoster viruses can have many ocular manifestations, some of which are serious and vision-threatening. […] The treatment for this is epithelial scraping with an instrument such as a Kimura spatula, along with trifluridine drops which was a huge advance at the time they were introduced and oral antivirals, such as acyclovir, valacyclovir and famciclovir, the most commonly used treatments among cornea specialists. […] In general, dendritic or geographic keratitis without stromal involvement are conditions where a topical antiviral is an appropriate therapy. […] Dr. Pepose believes that, even for patients with pure epithelial disease, its best to prescribe an oral antiviral. […] The treatment for this is steroids, but steroids can reactivate epithelial disease, so you can actually get the epithelial disease by treating the stromal disease.

• #3 Herpes Simplex Virus (HSV) Keratitis Treatment & Management: Approach Considerations, Infectious Epithelial Keratitis, Stromal Keratitis

  https://emedicine.medscape.com/article/1194268-treatment

  The major difficulties in treating herpetic keratitis relate to the tendency for recurrences and to the management of stromal disease. In its latent form, HSV can be present in the cells of the cornea and in the central connections of the trigeminal nerve, particularly in the trigeminal ganglion. Disturbance of host defense results in reactivation of the virus, its subsequent passage centrifugally along the nerve, and resultant shedding from the nerve endings. Corneal lesions occur when the balance between latency and reactivation is disturbed, such as during febrile illnesses, during menses, or on exposure to sunlight. Once trigger factors are identified, they need to be avoided. […] Using 400 mg of acyclovir once or twice daily as prophylaxis can reduce the incidence of recurrence. This is recommended for patients with recurrent stromal disease or more than 2 episodes of epithelial disease per year.

• #4 Ocular Herpes (Eye Herpes): Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/ocular-eye-herpes

  Theres no way to prevent eye herpes with 100% certainty. But there are several things you can do to significantly lower your risk of developing it, even if you catch one of the viruses that can cause it. […] Wash or sanitize your hands frequently. This makes it harder for these viruses to spread. […] Not sharing is caring. Oral herpes spreads easily via drinking containers (like water bottles and glasses), eating utensils, personal hygiene items, makeup, and other items. […] Sores or blisters are a sign to avoid contact. Avoid kissing or other forms of intimate contact with someone who has a sore or blister around their mouth or if you have one yourself. […] Get vaccinated. Chickenpox and shingles both can affect your eyes. Shingles can cause permanent, severe eye issues and vision loss (and other complications like severe nerve pain). Vaccination greatly reduces your risk of having those. You can also get the vaccine if you had shingles in the past to reduce the risk of having another recurrence. […] Manage your condition. If a healthcare provider diagnosed you with a viral condition that can cause eye herpes, they may recommend taking antiviral medication to prevent it from recurring.

• #5 Eye Herpes (Ocular Herpes) – All About Vision

  https://www.allaboutvision.com/conditions/infections-allergies/ocular-herpes/

  The only proven way to prevent herpes on your eye is to avoid a herpes simplex infection. But that can be hard or impossible for many. […] People who already carry the virus may be able to avoid flare-ups by limiting stress, sun exposure and other triggers as much as they can. […] Wash your hands regularly and try not to touch your eyes if you or someone close to you has a cold sore or ocular herpes. […] To lower your risk, your doctor might suggest: Wearing glasses instead of contacts, Washing your hands more often, Not touching your eyes or the areas around them anytime you have a cold sore, Avoiding certain steroid medications when possible, Taking long-term, low-dose antiviral medicine.

• #6 What Causes HSV (Herpes Simplex Virus) Keratitis | Healthy Contact Lens Wear and Care | CDC

  https://www.cdc.gov/contact-lenses/causes/what-causes-hsv-herpes-simplex-virus-keratitis.html

  HSV keratitis can lead to vision loss or blindness if left untreated. Maintain eye health while wearing contact lenses through proper daily habits and regular consultation with an eye doctor. […] Wash hands thoroughly before touching eyes, especially with cold sores or herpes blisters. […] Only use prescribed or recommended eye drops by an eye doctor or health care provider.

• #7 Eye herpes: Pictures, symptoms, and types

  https://www.medicalnewstoday.com/articles/321693

  As eye herpes can cause further infections, some doctors may recommend taking antiviral medicines regularly to reduce the risk of getting eye herpes again. […] Recurrent herpetic eye infections can lead to greater eye damage, which is why doctors aim to prevent their recurrence. Other prevention tips include: avoid touching the eyes, wash hands thoroughly, practice good hygiene, attend regular eye exams, use contact lenses as an eye doctor instructs.

• #8 Ocular Herpes (Eye Herpes): Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/ocular-eye-herpes

  Theres no way to prevent eye herpes with 100% certainty. But there are several things you can do to significantly lower your risk of developing it, even if you catch one of the viruses that can cause it. […] Wash or sanitize your hands frequently. This makes it harder for these viruses to spread. […] Not sharing is caring. Oral herpes spreads easily via drinking containers (like water bottles and glasses), eating utensils, personal hygiene items, makeup, and other items. […] Sores or blisters are a sign to avoid contact. Avoid kissing or other forms of intimate contact with someone who has a sore or blister around their mouth or if you have one yourself. […] Get vaccinated. Chickenpox and shingles both can affect your eyes. Shingles can cause permanent, severe eye issues and vision loss (and other complications like severe nerve pain). Vaccination greatly reduces your risk of having those. You can also get the vaccine if you had shingles in the past to reduce the risk of having another recurrence. […] Manage your condition. If a healthcare provider diagnosed you with a viral condition that can cause eye herpes, they may recommend taking antiviral medication to prevent it from recurring.

• #9

  https://www.aao.org/eye-health/diseases/herpes-keratitis

  There is no complete cure for herpes; once the virus is in the body, you cannot get rid of it. However, if you develop herpes keratitis, there are some things you can do to help prevent recurring outbreaks: […] If you have an active cold sore or blister, avoid touching your eyes. […] When herpes eye infections happen often, your doctor might place you on a preventative antiviral medication that you take by mouth. […] Steroids can increase the herpes virus in the body. You should not use steroid eye drops unless you are taking an anti-viral medicine as well. […] Stop wearing contact lenses if you keep getting infections. […] See an ophthalmologist immediately if symptoms of ocular herpes return.

• #10 Eye Herpes Disease: Symptoms, Treatment & More- K Health

  https://www.khealth.com/learn/herpes/eye/

  To avoid spreading HSV-1 to your eye you should consider the following: […] Avoid touching your eyes or the area around your eyes when you are having a herpes outbreak. […] Avoid contact lenses during a herpes outbreak, or if you absolutely have to wear them, wash your hands frequently and keep your contact lenses and related supplies clean. […] Only use eye drops that have been prescribed or recommended by an eye doctor or healthcare provider. […] Do not share eye products with anyone.

• #11 What Causes HSV (Herpes Simplex Virus) Keratitis | Healthy Contact Lens Wear and Care | CDC

  https://www.cdc.gov/contact-lenses/causes/what-causes-hsv-herpes-simplex-virus-keratitis.html

  HSV keratitis can lead to vision loss or blindness if left untreated. Maintain eye health while wearing contact lenses through proper daily habits and regular consultation with an eye doctor. […] Wash hands thoroughly before touching eyes, especially with cold sores or herpes blisters. […] Only use prescribed or recommended eye drops by an eye doctor or health care provider.

• #12 Keratitis – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/keratitis/symptoms-causes/syc-20374110

  Some forms of viral keratitis can’t be completely eliminated. But the following steps may control viral keratitis occurrences: […] If you have a cold sore or a herpes blister, avoid touching your eyes, your eyelids and the skin around your eyes unless you’ve thoroughly washed your hands. […] Only use eye drops that have been prescribed by an eye doctor. […] Washing your hands frequently can reduce viral outbreaks.

• #13 Herpes Eye Infections: Prevention And Treatment | Atlantic Eye Institute

  https://atlanticeyeinstitute.com/herpes-eye-infections-prevention-and-treatment/

  Herpes simplex viruses are highly contagious and can quickly spread to the eyes. […] Antiviral treatments are essential to prevent the severity of an infection. […] We recommend seeking treatment ASAP rather than waiting for an infection to clear on its own. […] The wrong treatment can worsen the infection and lead to permanent corneal scarring. […] The better you take care of your body by making healthy diet and lifestyle choices, the less often herpes is activated, and the swifter your body can fight off infections when they do flare up. […] We guarantee accurate diagnosis and immediate treatment to reduce the symptoms and side effects of herpes keratitis as soon as possible.

• #14 Ocular Herpes (Eye Herpes): Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/ocular-eye-herpes

  Theres no way to prevent eye herpes with 100% certainty. But there are several things you can do to significantly lower your risk of developing it, even if you catch one of the viruses that can cause it. […] Wash or sanitize your hands frequently. This makes it harder for these viruses to spread. […] Not sharing is caring. Oral herpes spreads easily via drinking containers (like water bottles and glasses), eating utensils, personal hygiene items, makeup, and other items. […] Sores or blisters are a sign to avoid contact. Avoid kissing or other forms of intimate contact with someone who has a sore or blister around their mouth or if you have one yourself. […] Get vaccinated. Chickenpox and shingles both can affect your eyes. Shingles can cause permanent, severe eye issues and vision loss (and other complications like severe nerve pain). Vaccination greatly reduces your risk of having those. You can also get the vaccine if you had shingles in the past to reduce the risk of having another recurrence. […] Manage your condition. If a healthcare provider diagnosed you with a viral condition that can cause eye herpes, they may recommend taking antiviral medication to prevent it from recurring.

• #15 Herpes Simplex Virus (HSV): Types Symptoms, & Treatment

  https://my.clevelandclinic.org/health/diseases/22855-herpes-simplex

  HSV is a common virus that spreads easily between people. So, its hard to prevent it. But you can lower your risk by: […] Avoiding close contact with people who have an HSV outbreak. For example, dont kiss someone who has a cold sore or have sexual contact with someone who has genital sores. […] Asking partners to get tested for sexually transmitted infections (STIs), including herpes. You can catch HSV from someone whos asymptomatic (no sores). Knowing a partner has HSV helps you to take precautions. […] Using protection (like condoms or dental dams) for all sexual activity. These will not protect you 100%. But theyll lower the risk of HSV spreading between partners. Protection doesnt cover all areas where HSV may shed. But they do cover some areas. Plus, theyll help protect you against other STIs.

• #16 Ocular Herpes (Eye Herpes): Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/ocular-eye-herpes

  Theres no way to prevent eye herpes with 100% certainty. But there are several things you can do to significantly lower your risk of developing it, even if you catch one of the viruses that can cause it. […] Wash or sanitize your hands frequently. This makes it harder for these viruses to spread. […] Not sharing is caring. Oral herpes spreads easily via drinking containers (like water bottles and glasses), eating utensils, personal hygiene items, makeup, and other items. […] Sores or blisters are a sign to avoid contact. Avoid kissing or other forms of intimate contact with someone who has a sore or blister around their mouth or if you have one yourself. […] Get vaccinated. Chickenpox and shingles both can affect your eyes. Shingles can cause permanent, severe eye issues and vision loss (and other complications like severe nerve pain). Vaccination greatly reduces your risk of having those. You can also get the vaccine if you had shingles in the past to reduce the risk of having another recurrence. […] Manage your condition. If a healthcare provider diagnosed you with a viral condition that can cause eye herpes, they may recommend taking antiviral medication to prevent it from recurring.

• #17 Cold sores | Better Health Channel

  https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/cold-sores

  If you have a cold sore, be sure to wash your hands after touching it and be especially careful to avoid touching your own eyes after touching your cold sore. It is the fluid contained in the blisters that is considered to be the most infectious. […] While you have a cold sore it is also important to avoid: sharing toothbrushes, sharing drinking glasses or bottles, sharing cutlery, sharing towels or other personal items, close contact (such as kissing and hugging) with newborn and young babies, kissing others, close contact with children with burns or eczema, close contact with people with weakened immune systems. […] If young children with a cold sore are unable to follow good hygiene practices, they should be excluded from childcare or school until the blister stops weeping. Blisters should be covered by a dressing, where possible. […] There is no cure for cold sores. Suggestions to reduce the number of outbreaks include: Avoid known triggers, if possible. Wear sunblock on your face and lips when outdoors. Pay attention to your general health and stress levels. Avoid getting ill or run down.

• #18 Treatment and prevention of herpes simplex virus type 1 in immunocompetent adolescents and adults – UpToDate

  https://www.uptodate.com/contents/treatment-and-prevention-of-herpes-simplex-virus-type-1-in-immunocompetent-adolescents-and-adults

  To reduce the risk of transmission, barrier use for oral sex is recommended. […] The decision to use valacyclovir to prevent sexual transmission of HSV-1 to an uninfected partner must be determined using shared decision making with the patient. […] To prevent transmission to others, athletes should not participate in contact sports until all herpes lesions have entered the dry crust stage.

• #19 Herpes Simplex Virus (HSV): Types Symptoms, & Treatment

  https://my.clevelandclinic.org/health/diseases/22855-herpes-simplex

  HSV is a common virus that spreads easily between people. So, its hard to prevent it. But you can lower your risk by: […] Avoiding close contact with people who have an HSV outbreak. For example, dont kiss someone who has a cold sore or have sexual contact with someone who has genital sores. […] Asking partners to get tested for sexually transmitted infections (STIs), including herpes. You can catch HSV from someone whos asymptomatic (no sores). Knowing a partner has HSV helps you to take precautions. […] Using protection (like condoms or dental dams) for all sexual activity. These will not protect you 100%. But theyll lower the risk of HSV spreading between partners. Protection doesnt cover all areas where HSV may shed. But they do cover some areas. Plus, theyll help protect you against other STIs.

• #20 Treatment and prevention of herpes simplex virus type 1 in immunocompetent adolescents and adults – UpToDate

  https://www.uptodate.com/contents/treatment-and-prevention-of-herpes-simplex-virus-type-1-in-immunocompetent-adolescents-and-adults

  To reduce the risk of transmission, barrier use for oral sex is recommended. […] The decision to use valacyclovir to prevent sexual transmission of HSV-1 to an uninfected partner must be determined using shared decision making with the patient. […] To prevent transmission to others, athletes should not participate in contact sports until all herpes lesions have entered the dry crust stage.

• #21 What Causes Contact Lens-related Eye Infections | Healthy Contact Lens Wear and Care | CDC

  https://www.cdc.gov/contact-lenses/causes/index.html

  Microbial keratitis can usually be prevented through proper eye health and care of contact lenses and supplies. […] If you experience unusual eye irritation: […] Promptly remove your contact lenses […] Avoid wearing contact lenses again until advised by your eye doctor […] See an eye doctor. […] Contact lenses are medical devices, and failure to wear, clean, and store them as directed can increase the risk of eye infections, such as microbial keratitis.

• #22 Keratitis – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/keratitis/symptoms-causes/syc-20374110

  If you wear contact lenses, proper use, cleaning and disinfecting can help prevent keratitis. Follow these tips: […] Choose daily wear contacts and take them out before going to sleep. […] Wash, rinse and dry your hands thoroughly before handling your contacts. […] Follow your eye care provider’s recommendations for taking care of your lenses. […] Use only sterile products that are made specifically for contact lens care, and use lens care products made for the type of lenses you wear. […] Replace your contact lenses as recommended. […] Replace your contact lens case every 3 to 6 months. […] Discard the solution in the contact lens case each time you disinfect your lenses. Don’t „top off” the old solution that’s already in the case. […] Don’t wear contact lenses when you go swimming.

• #23 Keratitis – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/keratitis/symptoms-causes/syc-20374110

  If you wear contact lenses, proper use, cleaning and disinfecting can help prevent keratitis. Follow these tips: […] Choose daily wear contacts and take them out before going to sleep. […] Wash, rinse and dry your hands thoroughly before handling your contacts. […] Follow your eye care provider’s recommendations for taking care of your lenses. […] Use only sterile products that are made specifically for contact lens care, and use lens care products made for the type of lenses you wear. […] Replace your contact lenses as recommended. […] Replace your contact lens case every 3 to 6 months. […] Discard the solution in the contact lens case each time you disinfect your lenses. Don’t „top off” the old solution that’s already in the case. […] Don’t wear contact lenses when you go swimming.

• #24 Keratitis – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/keratitis/symptoms-causes/syc-20374110

  If you wear contact lenses, proper use, cleaning and disinfecting can help prevent keratitis. Follow these tips: […] Choose daily wear contacts and take them out before going to sleep. […] Wash, rinse and dry your hands thoroughly before handling your contacts. […] Follow your eye care provider’s recommendations for taking care of your lenses. […] Use only sterile products that are made specifically for contact lens care, and use lens care products made for the type of lenses you wear. […] Replace your contact lenses as recommended. […] Replace your contact lens case every 3 to 6 months. […] Discard the solution in the contact lens case each time you disinfect your lenses. Don’t „top off” the old solution that’s already in the case. […] Don’t wear contact lenses when you go swimming.

• #25 Keratitis – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/keratitis/symptoms-causes/syc-20374110

  If you wear contact lenses, proper use, cleaning and disinfecting can help prevent keratitis. Follow these tips: […] Choose daily wear contacts and take them out before going to sleep. […] Wash, rinse and dry your hands thoroughly before handling your contacts. […] Follow your eye care provider’s recommendations for taking care of your lenses. […] Use only sterile products that are made specifically for contact lens care, and use lens care products made for the type of lenses you wear. […] Replace your contact lenses as recommended. […] Replace your contact lens case every 3 to 6 months. […] Discard the solution in the contact lens case each time you disinfect your lenses. Don’t „top off” the old solution that’s already in the case. […] Don’t wear contact lenses when you go swimming.

• #26 Keratitis – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/keratitis/symptoms-causes/syc-20374110

  If you wear contact lenses, proper use, cleaning and disinfecting can help prevent keratitis. Follow these tips: […] Choose daily wear contacts and take them out before going to sleep. […] Wash, rinse and dry your hands thoroughly before handling your contacts. […] Follow your eye care provider’s recommendations for taking care of your lenses. […] Use only sterile products that are made specifically for contact lens care, and use lens care products made for the type of lenses you wear. […] Replace your contact lenses as recommended. […] Replace your contact lens case every 3 to 6 months. […] Discard the solution in the contact lens case each time you disinfect your lenses. Don’t „top off” the old solution that’s already in the case. […] Don’t wear contact lenses when you go swimming.

• #27

  https://www.aao.org/eye-health/diseases/herpes-keratitis

  There is no complete cure for herpes; once the virus is in the body, you cannot get rid of it. However, if you develop herpes keratitis, there are some things you can do to help prevent recurring outbreaks: […] If you have an active cold sore or blister, avoid touching your eyes. […] When herpes eye infections happen often, your doctor might place you on a preventative antiviral medication that you take by mouth. […] Steroids can increase the herpes virus in the body. You should not use steroid eye drops unless you are taking an anti-viral medicine as well. […] Stop wearing contact lenses if you keep getting infections. […] See an ophthalmologist immediately if symptoms of ocular herpes return.

• #28 Eye Herpes: Causes, Treatment & What Not to Do – NVISION

  https://www.nvisioncenters.com/conditions/eye-herpes/

  Eye herpes can be controlled with antiviral medication, and it can be diagnosed during a routine eye exam. […] Avoid touching your eyes or sharing eye products if you have cold sores or know someone with eye herpes. Take any eye drops or oral medications as prescribed to manage the herpes virus. […] There are no clear ways to prevent the spread of herpes keratitis, but there are some steps you can take to keep your eyes safe. […] If you have cold sores, avoid touching your eyes. Wash your hands after you touch your lips during an outbreak to prevent spreading the virus to other areas. […] Do not share eye drops or eye makeup with others. The herpes virus can be transferred this way. […] Keep your contact lenses clean, as recommended by your optometrist. If you experience a herpes outbreak, throw out that pair of contacts. […] If outbreaks become frequent, they can be managed with regular, often daily, medication. […] While you may never need medication to treat eye herpes, it is important to get an appropriate diagnosis if you experience the symptoms listed above.

• #29 Herpes Simplex Virus (HSV) Keratitis Treatment & Management: Approach Considerations, Infectious Epithelial Keratitis, Stromal Keratitis

  https://emedicine.medscape.com/article/1194268-treatment

  The major difficulties in treating herpetic keratitis relate to the tendency for recurrences and to the management of stromal disease. In its latent form, HSV can be present in the cells of the cornea and in the central connections of the trigeminal nerve, particularly in the trigeminal ganglion. Disturbance of host defense results in reactivation of the virus, its subsequent passage centrifugally along the nerve, and resultant shedding from the nerve endings. Corneal lesions occur when the balance between latency and reactivation is disturbed, such as during febrile illnesses, during menses, or on exposure to sunlight. Once trigger factors are identified, they need to be avoided. […] Using 400 mg of acyclovir once or twice daily as prophylaxis can reduce the incidence of recurrence. This is recommended for patients with recurrent stromal disease or more than 2 episodes of epithelial disease per year.

• #30 Ocular Herpes

  https://scoallentown.com/condition/ocular-herpes

  Ocular herpes is transmitted through contact with someone who is having an outbreak, such as a cold sore. […] Once the initial outbreak occurs, ocular herpes has about a 50 percent chance of recurring. […] Outbreaks are caused by stress-related factors such as fever, sunburn, major dental or surgical procedures, and trauma.

• #31 Treatment and prevention of herpes simplex virus type 1 in immunocompetent adolescents and adults – UpToDate

  https://www.uptodate.com/contents/treatment-and-prevention-of-herpes-simplex-virus-type-1-in-immunocompetent-adolescents-and-adults

  PROPHYLAXIS FOR RECURRENT HSV WITH IDENTIFIED TRIGGER […] We advise patients with HSV-1 triggered by sunlight to use sunscreen. […] In general, we suggest not using prophylactic antiviral therapy for the sole purpose of preventing recurrences due to sunlight, since there are conflicting data on the benefit of antiviral therapy in this setting. […] Given the high risk of HSV reactivation associated with these procedures, we typically administer antiviral prophylaxis around the time of surgery, even to those without a known history of HSV. […] We initiate suppressive therapy with acyclovir (400 mg orally twice daily) or valacyclovir (500 mg orally once daily). […] Prophylactic oral therapy may prevent HSV reactivation during certain procedures, such as trigeminal nerve root decompression, facial dermabrasion, or ablative laser resurfacing.

• #32 Herpes Simplex (Eye Infection): Symptoms and Treatment

  https://patient.info/eye-care/eye-infection-herpes-simplex

  Herpes simplex is a virus that causes cold sores and genital herpes. However, it can also cause eye infections. […] If you have herpes simplex eye infection, you should not wear contact lenses until 24 hours after your symptoms and the infection have completely gone away. […] If recurrences are frequent or severe, your eye specialist may advise that you take antiviral tablets each day to prevent episodes of active infection. Studies have shown that, on average, the number of recurrences is roughly halved in people who take regular antiviral tablets. […] Some people say that episodes of active herpes infection may be triggered by strong sunlight. So, wearing sunglasses may also help to prevent recurrences.

• #33 Understanding Herpes Keratitis: Causes, Symptoms, and Treatment – Burman & Zuckerbrod Ophthalmology Associates

  https://www.2020detroit.com/understanding-herpes-keratitis/

  While there is no cure for herpes keratitis, certain measures can help manage and reduce the risk of recurrence: […] Identifying and avoiding triggers, such as excessive sunlight or stress, can help prevent outbreaks. […] Maintaining good hygiene, including regular hand washing and avoiding touching the eyes, can reduce the risk of spreading the virus. […] Wearing sunglasses or other protective eyewear can help minimize exposure to sunlight, which can trigger the virus. […] Regular check-ups with an ophthalmologist can help monitor eye health and catch any potential issues early.

• #34 Cold sores | Better Health Channel

  https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/cold-sores

  If you have a cold sore, be sure to wash your hands after touching it and be especially careful to avoid touching your own eyes after touching your cold sore. It is the fluid contained in the blisters that is considered to be the most infectious. […] While you have a cold sore it is also important to avoid: sharing toothbrushes, sharing drinking glasses or bottles, sharing cutlery, sharing towels or other personal items, close contact (such as kissing and hugging) with newborn and young babies, kissing others, close contact with children with burns or eczema, close contact with people with weakened immune systems. […] If young children with a cold sore are unable to follow good hygiene practices, they should be excluded from childcare or school until the blister stops weeping. Blisters should be covered by a dressing, where possible. […] There is no cure for cold sores. Suggestions to reduce the number of outbreaks include: Avoid known triggers, if possible. Wear sunblock on your face and lips when outdoors. Pay attention to your general health and stress levels. Avoid getting ill or run down.

• #35 Herpes Eye Infections: Prevention And Treatment | Atlantic Eye Institute

  https://atlanticeyeinstitute.com/herpes-eye-infections-prevention-and-treatment/

  Herpes simplex viruses are highly contagious and can quickly spread to the eyes. […] Antiviral treatments are essential to prevent the severity of an infection. […] We recommend seeking treatment ASAP rather than waiting for an infection to clear on its own. […] The wrong treatment can worsen the infection and lead to permanent corneal scarring. […] The better you take care of your body by making healthy diet and lifestyle choices, the less often herpes is activated, and the swifter your body can fight off infections when they do flare up. […] We guarantee accurate diagnosis and immediate treatment to reduce the symptoms and side effects of herpes keratitis as soon as possible.

• #36 Herpes Eye Disease in Children – Pediatric Eye Associates, LLC

  https://kideyedoc.com/herpes-eye-disease-in-children/

  Preventing herpes eye disease in children involves a combination of good hygiene practices, awareness, and minimizing the risk of exposure to the herpes simplex virus. Some examples of good practices include: […] Regular handwashing […] Avoid touching the face, especially when outside. […] Teach children not to share personal items like towels, washcloths, or tissues. […] Limit close contact during an outbreak. […] Encourage a healthy lifestyle, including proper nutrition, sufficient sleep, and stress management. […] Regular eye check-ups with a pediatric ophthalmologist or optometrist. This can help detect potential issues early on, allowing for timely intervention.

• #37

  https://www.healthychildren.org/English/health-issues/conditions/skin/Pages/Herpes-Simplex-Virus-Cold-Sores.aspx

  Cold sores are highly contagious. They can spread through saliva, skin-to-skin contact, or by touching an object handled by someone infected with the virus. […] Try to prevent your child from scratching or picking at cold sores. This can spread the virus to other parts of the body, such as fingers and eyes, as well as to other children who touch toys and other objects they play with. Wash hands and clean toys regularly. […] During a cold sore flare-up, don’t let your child share drinks or utensils, towels, toothpaste or other items to avoid spreading the infection through saliva. Also, wash items such as towels and linens in hot water after use. […] If your child participates in sports that involve skin-to-skin contact such as wrestling, he or she should sit out during an active cold sore infection. Make sure mats and other equipment are cleaned regularly after use. […] Skin irritation can bring on a cold sore outbreak, so be sure your child uses lotion and a lip balm containing sunscreen or zinc oxide before heading outdoors. […] Help your child manage stress, which can increase the likelihood of cold sore outbreaks.

• #38 Acyclovir for the prevention of recurrent herpes simplex virus eye disease. Herpetic Eye Disease Study Group – PubMed

  https://pubmed.ncbi.nlm.nih.gov/9696640/

  Long-term treatment with antiviral agents has been shown to prevent recurrences of genital and orofacial herpes simplex virus (HSV) disease, but it is uncertain whether prophylactic treatment can prevent recurrences of ocular HSV disease. […] After the resolution of ocular HSV disease, 12 months of treatment with acyclovir reduces the rate of recurrent ocular HSV disease and orofacial HSV disease. Long-term antiviral prophylaxis is most important for patients with a history of HSV stromal keratitis, since it can prevent additional episodes and potential loss of vision.

• #39 Treating HSV keratitis – EyeWorld

  https://www.eyeworld.org/2007/treating-hsv-keratitis/

  Patients with certain types of HSV are prone to recurrences. […] Some research, such as that from the HEDS investigators, indicates a role for oral antivirals to prevent these recurrences. […] Theres good evidence from the HED study that shows oral antiviral pills, such as the use of long-term acyclovir, can significantly reduce the risk for recurrences. […] The HEDS investigators found that long-term prophylaxis with oral antivirals can reduce recurrences by 50%. […] Dr. Chodosh recommends long-term oral acyclovir for patients with 1) multiple occurrences of HSV that each require corticosteroids, 2) recurrent inflammation with scarring or neovascularization that approaches the visual axis, 3) more than one episode of necrotizing keratitis, or 4) a history of herpetic eye disease and a corneal transplant. […] If patients with herpetic episodes must undergo eye surgery, Dr. Mah believes antiviral prophylaxis one day or a couple days before surgery, combined with post-op use for a couple of weeks, is another helpful measure.

• #40 How to Manage Ocular Herpes

  https://www.reviewofophthalmology.com/article/how-to-manage-ocular-herpes

  For people who have recurrent stromal keratitis, we recommend long-term steroid drops with either oral or topical antivirals to prophylax that. […] I prefer to add oral antivirals, as there could be some viral activity stimulating the immune response, but the role of oral antivirals in these cases is really prophylaxis against having recurrences. […] Many years ago, HEDS demonstrated that, if you treat patients with a history of stromal keratitis with a low prophylactic dose of oral acyclovir (400 mg twice daily), their chance of experiencing a recurrence decreased by around 40 percent. […] When HEDS was initiated in 1989, there was a lot of controversy about using steroids in patients with herpes. […] Patients with ocular herpes can also develop endotheliitis. […] Its generally treated with both oral acyclovir as well as topical steroids for the inflammation. […] Its really important to try to get them to re-epithelialize as quickly as possible. […] The question is whether theres a rationale for using prophylactic treatment to prevent recurrences of zoster, as is done with herpes simplex. […] Vaccination is the best way to prevent herpes zoster.

• #41 Herpes Helper

  https://www.reviewofoptometry.com/article/herpes-helper

  Antiviral prophylaxis has been used for decades in patients with herpes simplex keratitis. […] The study found an approximate 50% decrease in recurrence of ocular herpes with the one year of 400mg acyclovir used twice daily, and with no rebound effect when it was stopped for six months. […] While the dosages vary per patient, the current standard prophylactic dose of acyclovir is 400mg BID, valacyclovir 500mg QD and famciclovir 250mg one to two times a day; however, the length of prophylaxis has not been fully established. […] Most surgeons who perform a corneal graft in an eye with herpes simplex keratitis will continue their prophylaxis for many years, if not for life, declares Dr. Rapuano. […] HEDS demonstrated a 50% decrease in ocular herpes, not 100% elimination, Dr. Rapuano reminds.

• #42 Herpes Simplex: Ocular Manifestations and Management

  https://eyesoneyecare.com/resources/herpes-simplex-ocular-manifestations-management/

  The Herpetic Eye Disease Study (HEDS II) is known as the Herpetic Eye Disease Study Acyclovir Prevention Trial. This study was designed to determine the efficacy of a prophylactic dose of 400mg of acyclovir twice daily on the rate of recurrence. […] To minimize recurrences, prophylactic treatment should be considered for at least 1 year. Patients who have had more than one episode of HSV keratitis and those with HSV stromal keratitis are good candidates for a maintenance course of oral antivirals. The prophylactic dosage is as follows: Acyclovir 400mg BID, valacyclovir 500mg QD, or famciclovir 250mg BID. […] It is important to avoid or minimize steroids in the active replicating virus phase of a herpetic infection. Additionally, in patients using steroids, antiviral coverage is often used to prevent the recurrence of epithelial disease.

• #43 Treatment and prevention of herpes simplex virus type 1 in immunocompetent adolescents and adults – UpToDate

  https://www.uptodate.com/contents/treatment-and-prevention-of-herpes-simplex-virus-type-1-in-immunocompetent-adolescents-and-adults

  PROPHYLAXIS FOR RECURRENT HSV WITH IDENTIFIED TRIGGER […] We advise patients with HSV-1 triggered by sunlight to use sunscreen. […] In general, we suggest not using prophylactic antiviral therapy for the sole purpose of preventing recurrences due to sunlight, since there are conflicting data on the benefit of antiviral therapy in this setting. […] Given the high risk of HSV reactivation associated with these procedures, we typically administer antiviral prophylaxis around the time of surgery, even to those without a known history of HSV. […] We initiate suppressive therapy with acyclovir (400 mg orally twice daily) or valacyclovir (500 mg orally once daily). […] Prophylactic oral therapy may prevent HSV reactivation during certain procedures, such as trigeminal nerve root decompression, facial dermabrasion, or ablative laser resurfacing.

• #44 Herpes Simplex Uveitis – EyeWiki

  https://eyewiki.org/Herpes_Simplex_Uveitis

  There is no evidence of primary prevention strategies for HSV iritis or ocular HSV. […] Long term, low dose, systemic antiviral therapy may be beneficial for some patients, in order to decrease the frequency of recurrences of iritis. At present, controlled studies to show this are lacking. One might expect the HEDS study findings on prophylaxis may be generalizable to iritis, but this cannot be certain given the low number of strictly iritis patients. Oral doses for prophylaxis for ocular herpes simplex disease are acyclovir, 400 mg twice per day or valacyclovir, 500-1000 mg daily.

• #45 Herpes Simplex Uveitis – EyeWiki

  https://eyewiki.org/Herpes_Simplex_Uveitis

  There is no evidence of primary prevention strategies for HSV iritis or ocular HSV. […] Long term, low dose, systemic antiviral therapy may be beneficial for some patients, in order to decrease the frequency of recurrences of iritis. At present, controlled studies to show this are lacking. One might expect the HEDS study findings on prophylaxis may be generalizable to iritis, but this cannot be certain given the low number of strictly iritis patients. Oral doses for prophylaxis for ocular herpes simplex disease are acyclovir, 400 mg twice per day or valacyclovir, 500-1000 mg daily.

• #46 Herpes Helper

  https://www.reviewofoptometry.com/article/herpes-helper

  Antiviral prophylaxis has been used for decades in patients with herpes simplex keratitis. […] The study found an approximate 50% decrease in recurrence of ocular herpes with the one year of 400mg acyclovir used twice daily, and with no rebound effect when it was stopped for six months. […] While the dosages vary per patient, the current standard prophylactic dose of acyclovir is 400mg BID, valacyclovir 500mg QD and famciclovir 250mg one to two times a day; however, the length of prophylaxis has not been fully established. […] Most surgeons who perform a corneal graft in an eye with herpes simplex keratitis will continue their prophylaxis for many years, if not for life, declares Dr. Rapuano. […] HEDS demonstrated a 50% decrease in ocular herpes, not 100% elimination, Dr. Rapuano reminds.

• #47 Herpes Helper

  https://www.reviewofoptometry.com/article/herpes-helper

  Antiviral prophylaxis has been used for decades in patients with herpes simplex keratitis. […] The study found an approximate 50% decrease in recurrence of ocular herpes with the one year of 400mg acyclovir used twice daily, and with no rebound effect when it was stopped for six months. […] While the dosages vary per patient, the current standard prophylactic dose of acyclovir is 400mg BID, valacyclovir 500mg QD and famciclovir 250mg one to two times a day; however, the length of prophylaxis has not been fully established. […] Most surgeons who perform a corneal graft in an eye with herpes simplex keratitis will continue their prophylaxis for many years, if not for life, declares Dr. Rapuano. […] HEDS demonstrated a 50% decrease in ocular herpes, not 100% elimination, Dr. Rapuano reminds.

• #48 Treating HSV keratitis – EyeWorld

  https://www.eyeworld.org/2007/treating-hsv-keratitis/

  Patients with certain types of HSV are prone to recurrences. […] Some research, such as that from the HEDS investigators, indicates a role for oral antivirals to prevent these recurrences. […] Theres good evidence from the HED study that shows oral antiviral pills, such as the use of long-term acyclovir, can significantly reduce the risk for recurrences. […] The HEDS investigators found that long-term prophylaxis with oral antivirals can reduce recurrences by 50%. […] Dr. Chodosh recommends long-term oral acyclovir for patients with 1) multiple occurrences of HSV that each require corticosteroids, 2) recurrent inflammation with scarring or neovascularization that approaches the visual axis, 3) more than one episode of necrotizing keratitis, or 4) a history of herpetic eye disease and a corneal transplant. […] If patients with herpetic episodes must undergo eye surgery, Dr. Mah believes antiviral prophylaxis one day or a couple days before surgery, combined with post-op use for a couple of weeks, is another helpful measure.

• #49 Herpes Simplex: Ocular Manifestations and Management

  https://eyesoneyecare.com/resources/herpes-simplex-ocular-manifestations-management/

  The Herpetic Eye Disease Study (HEDS II) is known as the Herpetic Eye Disease Study Acyclovir Prevention Trial. This study was designed to determine the efficacy of a prophylactic dose of 400mg of acyclovir twice daily on the rate of recurrence. […] To minimize recurrences, prophylactic treatment should be considered for at least 1 year. Patients who have had more than one episode of HSV keratitis and those with HSV stromal keratitis are good candidates for a maintenance course of oral antivirals. The prophylactic dosage is as follows: Acyclovir 400mg BID, valacyclovir 500mg QD, or famciclovir 250mg BID. […] It is important to avoid or minimize steroids in the active replicating virus phase of a herpetic infection. Additionally, in patients using steroids, antiviral coverage is often used to prevent the recurrence of epithelial disease.

• #50 Treating HSV keratitis – EyeWorld

  https://www.eyeworld.org/2007/treating-hsv-keratitis/

  Patients with certain types of HSV are prone to recurrences. […] Some research, such as that from the HEDS investigators, indicates a role for oral antivirals to prevent these recurrences. […] Theres good evidence from the HED study that shows oral antiviral pills, such as the use of long-term acyclovir, can significantly reduce the risk for recurrences. […] The HEDS investigators found that long-term prophylaxis with oral antivirals can reduce recurrences by 50%. […] Dr. Chodosh recommends long-term oral acyclovir for patients with 1) multiple occurrences of HSV that each require corticosteroids, 2) recurrent inflammation with scarring or neovascularization that approaches the visual axis, 3) more than one episode of necrotizing keratitis, or 4) a history of herpetic eye disease and a corneal transplant. […] If patients with herpetic episodes must undergo eye surgery, Dr. Mah believes antiviral prophylaxis one day or a couple days before surgery, combined with post-op use for a couple of weeks, is another helpful measure.

• #51 Acyclovir for the prevention of recurrent herpes simplex virus eye disease. Herpetic Eye Disease Study Group – PubMed

  https://pubmed.ncbi.nlm.nih.gov/9696640/

  Long-term treatment with antiviral agents has been shown to prevent recurrences of genital and orofacial herpes simplex virus (HSV) disease, but it is uncertain whether prophylactic treatment can prevent recurrences of ocular HSV disease. […] After the resolution of ocular HSV disease, 12 months of treatment with acyclovir reduces the rate of recurrent ocular HSV disease and orofacial HSV disease. Long-term antiviral prophylaxis is most important for patients with a history of HSV stromal keratitis, since it can prevent additional episodes and potential loss of vision.

• #52 Herpes Simplex Eye Infections: Symptoms and Treatment

  https://patient.info/doctor/herpes-simplex-eye-infections

  Patients with multiple episodes of epithelial or stromal disease may be considered for prophylactic oral antivirals (such as aciclovir 400 mg twice daily for a year). This has been shown to reduce incidence of recurrence of the disease during this time if this is not their first episode of HSV activation. […] There is also some limited evidence suggesting that oral aciclovir may help reduce the recurrence rate (and graft rejection rate) in corneal transplant patients.

• #53 Treating HSV keratitis – EyeWorld

  https://www.eyeworld.org/2007/treating-hsv-keratitis/

  Patients with certain types of HSV are prone to recurrences. […] Some research, such as that from the HEDS investigators, indicates a role for oral antivirals to prevent these recurrences. […] Theres good evidence from the HED study that shows oral antiviral pills, such as the use of long-term acyclovir, can significantly reduce the risk for recurrences. […] The HEDS investigators found that long-term prophylaxis with oral antivirals can reduce recurrences by 50%. […] Dr. Chodosh recommends long-term oral acyclovir for patients with 1) multiple occurrences of HSV that each require corticosteroids, 2) recurrent inflammation with scarring or neovascularization that approaches the visual axis, 3) more than one episode of necrotizing keratitis, or 4) a history of herpetic eye disease and a corneal transplant. […] If patients with herpetic episodes must undergo eye surgery, Dr. Mah believes antiviral prophylaxis one day or a couple days before surgery, combined with post-op use for a couple of weeks, is another helpful measure.

• #54 Treating HSV keratitis – EyeWorld

  https://www.eyeworld.org/2007/treating-hsv-keratitis/

  Patients with certain types of HSV are prone to recurrences. […] Some research, such as that from the HEDS investigators, indicates a role for oral antivirals to prevent these recurrences. […] Theres good evidence from the HED study that shows oral antiviral pills, such as the use of long-term acyclovir, can significantly reduce the risk for recurrences. […] The HEDS investigators found that long-term prophylaxis with oral antivirals can reduce recurrences by 50%. […] Dr. Chodosh recommends long-term oral acyclovir for patients with 1) multiple occurrences of HSV that each require corticosteroids, 2) recurrent inflammation with scarring or neovascularization that approaches the visual axis, 3) more than one episode of necrotizing keratitis, or 4) a history of herpetic eye disease and a corneal transplant. […] If patients with herpetic episodes must undergo eye surgery, Dr. Mah believes antiviral prophylaxis one day or a couple days before surgery, combined with post-op use for a couple of weeks, is another helpful measure.

• #55 Herpes Simplex Ophthalmicus – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK559194/

  Herpes simplex ophthalmicus is an eye infection by the herpes simplex type 1 and type 2 viruses. […] Early diagnosis and treatment are keys to preventing complications. […] Oral antiviral prophylaxis of pregnant women at 36 weeks and opting for elective cesarean delivery prevents neonatal spread during birth. […] Long term oral antiviral prophylaxis prevents recurrences in corneal graft and stromal keratitis and keratouveitis. […] Long term oral antiviral prophylaxis prevents recurrences in corneal graft following penetrating keratoplasty for uncontrolled epithelial keratitis or for dense stromal scar secondary to HSV keratitis.

• #56 Treating HSV keratitis – EyeWorld

  https://www.eyeworld.org/2007/treating-hsv-keratitis/

  Patients with certain types of HSV are prone to recurrences. […] Some research, such as that from the HEDS investigators, indicates a role for oral antivirals to prevent these recurrences. […] Theres good evidence from the HED study that shows oral antiviral pills, such as the use of long-term acyclovir, can significantly reduce the risk for recurrences. […] The HEDS investigators found that long-term prophylaxis with oral antivirals can reduce recurrences by 50%. […] Dr. Chodosh recommends long-term oral acyclovir for patients with 1) multiple occurrences of HSV that each require corticosteroids, 2) recurrent inflammation with scarring or neovascularization that approaches the visual axis, 3) more than one episode of necrotizing keratitis, or 4) a history of herpetic eye disease and a corneal transplant. […] If patients with herpetic episodes must undergo eye surgery, Dr. Mah believes antiviral prophylaxis one day or a couple days before surgery, combined with post-op use for a couple of weeks, is another helpful measure.

• #57 Antiviral Therapy Associated with Fewer Recurring Eye Problems from Herpes Simplex Virus

  https://www.infectioncontroltoday.com/view/antiviral-therapy-associated-fewer-recurring-eye-problems-herpes-simplex-virus

  Taking oral antiviral medications following infection with the herpes simplex virus may be associated with a reduced risk of recurring eye-related manifestations of the disease, according to a report in the September issue of Archives of Ophthalmology. […] Patients not taking this prophylactic therapy were 9.4 times more likely to have a recurrence of epithelial keratitis, 8.4 times more likely to have a recurrence of stromal keratitis and 34.5 times more likely to have a recurrence of blepharitis or conjunctivitis than those taking antiviral medications. […] A total of 20 patients experienced adverse outcomes, including visual loss and perforation of the cornea; of these, 17 (85 percent) were not taking oral antiviral prophylaxis. […] „The results of this study suggest that oral antiviral prophylaxis should be considered for patients with frequent recurrences of corneal disease,” they conclude. „Additionally, we recommend an evaluation of the possible barriers preventing compliance with antiviral prophylaxis and a reassessment of the cost-effectiveness of long-term oral antiviral therapy.”

• #58 Treatment and prevention of herpes simplex virus type 1 in immunocompetent adolescents and adults – UpToDate

  https://www.uptodate.com/contents/treatment-and-prevention-of-herpes-simplex-virus-type-1-in-immunocompetent-adolescents-and-adults

  PROPHYLAXIS FOR RECURRENT HSV WITH IDENTIFIED TRIGGER […] We advise patients with HSV-1 triggered by sunlight to use sunscreen. […] In general, we suggest not using prophylactic antiviral therapy for the sole purpose of preventing recurrences due to sunlight, since there are conflicting data on the benefit of antiviral therapy in this setting. […] Given the high risk of HSV reactivation associated with these procedures, we typically administer antiviral prophylaxis around the time of surgery, even to those without a known history of HSV. […] We initiate suppressive therapy with acyclovir (400 mg orally twice daily) or valacyclovir (500 mg orally once daily). […] Prophylactic oral therapy may prevent HSV reactivation during certain procedures, such as trigeminal nerve root decompression, facial dermabrasion, or ablative laser resurfacing.

• #59 Herpes Simplex Virus (HSV) Keratitis Treatment & Management: Approach Considerations, Infectious Epithelial Keratitis, Stromal Keratitis

  https://emedicine.medscape.com/article/1194268-treatment

  Active HSV keratitis is an absolute contraindication to laser corneal refractive surgery (ie, LASIK, PRK) or other corneal procedures (collagen cross-linking). Inactive keratitis or a history of previous HSV disease also is considered a relative contraindication. Recurrence of HSV keratitis after refractive surgery is a well-known complication. However, case reports have documented good refractive surgery outcomes in selected patients whose keratitis has been inactive for at least 1 year and in whom perioperative systemic antiviral prophylaxis is used. […] Ongoing research into HSV vaccination is being conducted. While nearly all developmental vaccines are targeting HSV-2 and genital herpes, evidence suggests that these vaccines may offer cross-protection in preventing ocular HSV-1 infections. However, concerns remain that a boost in immune response to HSV after vaccination may exacerbate herpetic stromal keratitis.

• #60 CRSToday | Herpes Simplex Virus Keratitis

  https://crstoday.com/articles/2007-apr/crst0407_02-php

  My standard approach is to start oral acyclovir 400 mg b.i.d. at the time of cataract surgery, and I ask the patient to continue the drug for 1 month while he is on a tapering dose of a topical steroid. […] Topical steroids are the treatment of choice for both the management and prophylaxis of the recurrent inflammatory processes in HSV immune stromal keratitis. […] I would start acyclovir 400 mg orally b.i.d. at the time of surgery and continue it for 1 month postoperatively as he tapered his topical prednisolone acetate. […] My recommendations regarding antiviral prophylaxis include starting the patient on oral acyclovir at 400 mg b.i.d. (or the equivalent dose of valacyclovir or famciclovir) along with topical prednisolone acetate 1 q.i.d. for at least 2 weeks prior to cataract surgery.

• #61 CRSToday | Herpes Simplex Virus Keratitis

  https://crstoday.com/articles/2007-apr/crst0407_02-php

  The combination of his documented history of HSV keratitis and an obvious nummular corneal scar with associated vascularization (albeit inactive) warrants topical and oral therapy. […] The study also showed that oral acyclovir can decrease the frequency of recurrent HSV keratitis, especially in patients with a history of stromal disease. […] Given the landmark HEDS, it would be most prudent to start the patient on acyclovir 400 mg b.i.d. 2 or 3 days before surgery. […] I would commence therapy early, because stress alone could cause a recurrence of HSV keratitis, and I want the level of the drug to be high enough to produce effective prophylaxis. […] I would continue the oral prophylaxis for 1 month or at least until the epithelium had healed, the normal postoperative inflammation had resolved, and/or the topical anti-inflammatory medications (steroid and/or NSAID) were discontinued, because these medications can facilitate a recurrence.

• #62 Corneal Refractive Surgery in Patients with a History of Herpes Simple | OPTH

  https://www.dovepress.com/corneal-refractive-surgery-in-patients-with-a-history-of-herpes-simple-peer-reviewed-fulltext-article-OPTH

  Corneal Refractive Surgery HSV Prophylaxis: While there is strong evidence to suggest that oral acyclovir reduces the recurrence of ocular HSV, there are few studies that discuss prophylaxis prior to refractive surgery. […] For LASIK, oral acyclovir 400 mg twice daily or valacyclovir 500 mg once daily for two weeks before and continued for 2 weeks after surgery is suggested. For PRK, SMILE, and other corneal refractive procedures, begin oral acyclovir 400 mg twice daily or valacyclovir 500 mg once daily for two weeks before surgery and continue course postoperatively until cessation of topical steroids. […] We recommend starting the prophylaxis two weeks prior to surgery as supported by the prospective study of De Rojas et al wherein no recurrence was seen. […] If there is a concern for resistance due to previously failed prophylaxis or prolonged disease course despite treatment, we recommend that these patients be strongly counseled to avoid corneal refractive surgery due to the higher risk of HSK reactivation.

• #63 Corneal Refractive Surgery in Patients with a History of Herpes Simple | OPTH

  https://www.dovepress.com/corneal-refractive-surgery-in-patients-with-a-history-of-herpes-simple-peer-reviewed-fulltext-article-OPTH

  Corneal Refractive Surgery HSV Prophylaxis: While there is strong evidence to suggest that oral acyclovir reduces the recurrence of ocular HSV, there are few studies that discuss prophylaxis prior to refractive surgery. […] For LASIK, oral acyclovir 400 mg twice daily or valacyclovir 500 mg once daily for two weeks before and continued for 2 weeks after surgery is suggested. For PRK, SMILE, and other corneal refractive procedures, begin oral acyclovir 400 mg twice daily or valacyclovir 500 mg once daily for two weeks before surgery and continue course postoperatively until cessation of topical steroids. […] We recommend starting the prophylaxis two weeks prior to surgery as supported by the prospective study of De Rojas et al wherein no recurrence was seen. […] If there is a concern for resistance due to previously failed prophylaxis or prolonged disease course despite treatment, we recommend that these patients be strongly counseled to avoid corneal refractive surgery due to the higher risk of HSK reactivation.

• #64 Herpes Simplex Virus (HSV) Keratitis Treatment & Management: Approach Considerations, Infectious Epithelial Keratitis, Stromal Keratitis

  https://emedicine.medscape.com/article/1194268-treatment

  Active HSV keratitis is an absolute contraindication to laser corneal refractive surgery (ie, LASIK, PRK) or other corneal procedures (collagen cross-linking). Inactive keratitis or a history of previous HSV disease also is considered a relative contraindication. Recurrence of HSV keratitis after refractive surgery is a well-known complication. However, case reports have documented good refractive surgery outcomes in selected patients whose keratitis has been inactive for at least 1 year and in whom perioperative systemic antiviral prophylaxis is used. […] Ongoing research into HSV vaccination is being conducted. While nearly all developmental vaccines are targeting HSV-2 and genital herpes, evidence suggests that these vaccines may offer cross-protection in preventing ocular HSV-1 infections. However, concerns remain that a boost in immune response to HSV after vaccination may exacerbate herpetic stromal keratitis.

• #65 Herpes Simplex Ophthalmicus – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK559194/

  Herpes simplex ophthalmicus is an eye infection by the herpes simplex type 1 and type 2 viruses. […] Early diagnosis and treatment are keys to preventing complications. […] Oral antiviral prophylaxis of pregnant women at 36 weeks and opting for elective cesarean delivery prevents neonatal spread during birth. […] Long term oral antiviral prophylaxis prevents recurrences in corneal graft and stromal keratitis and keratouveitis. […] Long term oral antiviral prophylaxis prevents recurrences in corneal graft following penetrating keratoplasty for uncontrolled epithelial keratitis or for dense stromal scar secondary to HSV keratitis.

• #66 Genital herpes – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/genital-herpes/symptoms-causes/syc-20356161

  Prevention of genital herpes is the same as preventing other sexually transmitted infections. […] Use a condom or dental dam during sexual activity. These reduce the risk of disease, but they don’t prevent all skin-to-skin contact during sex. […] Don’t have sex when a partner with genital herpes has symptoms. […] If you are pregnant and know you have genital herpes, tell your health care provider. […] Your provider may recommend that you take herpes antiviral medicines late in pregnancy. This is to try to prevent an outbreak around the time of delivery. If you have an outbreak when you go into labor, your provider may suggest a cesarean section. That is a surgery to remove the baby from your uterus. It lowers the risk of passing the virus to your baby.

• #67 Herpes Simplex Ophthalmicus – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK559194/

  Herpes simplex ophthalmicus is an eye infection by the herpes simplex type 1 and type 2 viruses. […] Early diagnosis and treatment are keys to preventing complications. […] Oral antiviral prophylaxis of pregnant women at 36 weeks and opting for elective cesarean delivery prevents neonatal spread during birth. […] Long term oral antiviral prophylaxis prevents recurrences in corneal graft and stromal keratitis and keratouveitis. […] Long term oral antiviral prophylaxis prevents recurrences in corneal graft following penetrating keratoplasty for uncontrolled epithelial keratitis or for dense stromal scar secondary to HSV keratitis.

• #68 Herpes simplex infectionsExternal LinkExternal LinkExternal LinkExternal Link

  https://www.health.vic.gov.au/infectious-diseases/herpes-simplex-infections

  Health education and personal hygiene should be directed towards minimising transfer of infectious material and reducing the risk of exposure of high-risk groups. […] Emphasise personal hygiene to minimise the transfer of infectious material. Avoiding skin contact from the time of first symptoms (warning 'tingle’) on the mouth, genitals or anus, and for a week after the symptoms have gone helps prevent transmission. […] Wear gloves when in direct contact with infectious lesions, and wash hands with soap and water afterwards. […] Correct and consistent use of condoms during sexual intercourse decreases the risk of infection. […] Preventive antiviral medication (suppressive therapy) when recurrences are frequent can reduce the risk of transmission. […] Sun protection is important in preventing recurrences of facial herpes simplex. […] Patients with active lesions should have no contact with newborns, children with burns or eczema, or immunosuppressed patients. Consider caesarean section before the membranes rupture when primary or recurrent genital infections occur in late pregnancy, to minimise the risk of neonatal infection.

• #69 Cold sores | Better Health Channel

  https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/cold-sores

  If you have a cold sore, be sure to wash your hands after touching it and be especially careful to avoid touching your own eyes after touching your cold sore. It is the fluid contained in the blisters that is considered to be the most infectious. […] While you have a cold sore it is also important to avoid: sharing toothbrushes, sharing drinking glasses or bottles, sharing cutlery, sharing towels or other personal items, close contact (such as kissing and hugging) with newborn and young babies, kissing others, close contact with children with burns or eczema, close contact with people with weakened immune systems. […] If young children with a cold sore are unable to follow good hygiene practices, they should be excluded from childcare or school until the blister stops weeping. Blisters should be covered by a dressing, where possible. […] There is no cure for cold sores. Suggestions to reduce the number of outbreaks include: Avoid known triggers, if possible. Wear sunblock on your face and lips when outdoors. Pay attention to your general health and stress levels. Avoid getting ill or run down.

• #70 Herpes Simplex Virus (HSV) Keratitis Treatment & Management: Approach Considerations, Infectious Epithelial Keratitis, Stromal Keratitis

  https://emedicine.medscape.com/article/1194268-treatment

  Active HSV keratitis is an absolute contraindication to laser corneal refractive surgery (ie, LASIK, PRK) or other corneal procedures (collagen cross-linking). Inactive keratitis or a history of previous HSV disease also is considered a relative contraindication. Recurrence of HSV keratitis after refractive surgery is a well-known complication. However, case reports have documented good refractive surgery outcomes in selected patients whose keratitis has been inactive for at least 1 year and in whom perioperative systemic antiviral prophylaxis is used. […] Ongoing research into HSV vaccination is being conducted. While nearly all developmental vaccines are targeting HSV-2 and genital herpes, evidence suggests that these vaccines may offer cross-protection in preventing ocular HSV-1 infections. However, concerns remain that a boost in immune response to HSV after vaccination may exacerbate herpetic stromal keratitis.

• #71 Prevention of Herpes Simplex Virus Induced Stromal Keratitis by a Glycoprotein B-Specific Monoclonal Antibody | PLOS One

  https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0116800

  Prevention of Herpes Simplex Virus Induced Stromal Keratitis by a Glycoprotein B-Specific Monoclonal Antibody […] The increasing incidence of acyclovir (ACV) and multidrug-resistant strains in patients with corneal HSV-1 infections leading to Herpetic Stromal Keratitis (HSK) is a major health problem in industrialized countries and often results in blindness. […] In conclusion, our data demonstrate that mAb 2c proved to be an excellent drug for the treatment of corneal HSV-infections and for prevention of HSK and blindness. […] Consequently, the objectives of the present study were to examine the neutralizing capacity of the HSV-gB-specific monoclonal antibody towards the eye-pathogenic HSV-1 strain KOS and ACV-resistant clinical isolates in vitro and its efficacy in prevention of HSK in the immunocompetent murine BALB/c model.

• #72 Ocular Herpes (Eye Herpes): Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/ocular-eye-herpes

  Theres no way to prevent eye herpes with 100% certainty. But there are several things you can do to significantly lower your risk of developing it, even if you catch one of the viruses that can cause it. […] Wash or sanitize your hands frequently. This makes it harder for these viruses to spread. […] Not sharing is caring. Oral herpes spreads easily via drinking containers (like water bottles and glasses), eating utensils, personal hygiene items, makeup, and other items. […] Sores or blisters are a sign to avoid contact. Avoid kissing or other forms of intimate contact with someone who has a sore or blister around their mouth or if you have one yourself. […] Get vaccinated. Chickenpox and shingles both can affect your eyes. Shingles can cause permanent, severe eye issues and vision loss (and other complications like severe nerve pain). Vaccination greatly reduces your risk of having those. You can also get the vaccine if you had shingles in the past to reduce the risk of having another recurrence. […] Manage your condition. If a healthcare provider diagnosed you with a viral condition that can cause eye herpes, they may recommend taking antiviral medication to prevent it from recurring.

• #73 How to Manage Ocular Herpes

  https://www.reviewofophthalmology.com/article/how-to-manage-ocular-herpes

  For people who have recurrent stromal keratitis, we recommend long-term steroid drops with either oral or topical antivirals to prophylax that. […] I prefer to add oral antivirals, as there could be some viral activity stimulating the immune response, but the role of oral antivirals in these cases is really prophylaxis against having recurrences. […] Many years ago, HEDS demonstrated that, if you treat patients with a history of stromal keratitis with a low prophylactic dose of oral acyclovir (400 mg twice daily), their chance of experiencing a recurrence decreased by around 40 percent. […] When HEDS was initiated in 1989, there was a lot of controversy about using steroids in patients with herpes. […] Patients with ocular herpes can also develop endotheliitis. […] Its generally treated with both oral acyclovir as well as topical steroids for the inflammation. […] Its really important to try to get them to re-epithelialize as quickly as possible. […] The question is whether theres a rationale for using prophylactic treatment to prevent recurrences of zoster, as is done with herpes simplex. […] Vaccination is the best way to prevent herpes zoster.

• #74 Herpes Eye Infections | 5-Minute Clinical Consult

  https://www.unboundmedicine.com/5minute/view/5-Minute-Clinical-Consult/116272/all/Herpes_Eye_Infections

  Acyclovir can be used prophylactically to prevent recurrence of ocular HSV. […] Contact precautions with active lesions (HSV and VZV) […] Pregnant women without history of chickenpox should avoid contact with persons with active zoster. […] Pregnancy increases risk of recurrence of HSV/VZV. […] Varicella recombinant zoster vaccine (Shingrix) (VZV only): 2 doses 2 to 6 months apart recommended by the CDC for all persons aged 50 years.

• #75 Ocular Herpes: Symptoms and Treatments, Assil Eye Institute

  https://assileye.com/blog/ocular-herpes/

  While theres no prevention for the herpes simplex viral infection, you can get a vaccine to prevent the varicella-zoster virus (shingles). The Centers for Disease Control (CDC) recommends this vaccine for people 60 and older because it reduces your risk of shingles by more than fifty percent. […] Whats more, the shingles vaccine can reduce your odds of having long-term nerve damage by more than 66 percent.

• #76 Herpes Simplex Ophthalmicus – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK559194/

  Herpes simplex ophthalmicus is an eye infection by the herpes simplex type 1 and type 2 viruses. […] Early diagnosis and treatment are keys to preventing complications. […] Oral antiviral prophylaxis of pregnant women at 36 weeks and opting for elective cesarean delivery prevents neonatal spread during birth. […] Long term oral antiviral prophylaxis prevents recurrences in corneal graft and stromal keratitis and keratouveitis. […] Long term oral antiviral prophylaxis prevents recurrences in corneal graft following penetrating keratoplasty for uncontrolled epithelial keratitis or for dense stromal scar secondary to HSV keratitis.

• #77 Herpes Simplex Eye Infections: Symptoms and Treatment

  https://patient.info/doctor/herpes-simplex-eye-infections

  Patients with multiple episodes of epithelial or stromal disease may be considered for prophylactic oral antivirals (such as aciclovir 400 mg twice daily for a year). This has been shown to reduce incidence of recurrence of the disease during this time if this is not their first episode of HSV activation. […] There is also some limited evidence suggesting that oral aciclovir may help reduce the recurrence rate (and graft rejection rate) in corneal transplant patients.

• #78 Herpes Helper

  https://www.reviewofoptometry.com/article/herpes-helper

  Antiviral prophylaxis has been used for decades in patients with herpes simplex keratitis. […] The study found an approximate 50% decrease in recurrence of ocular herpes with the one year of 400mg acyclovir used twice daily, and with no rebound effect when it was stopped for six months. […] While the dosages vary per patient, the current standard prophylactic dose of acyclovir is 400mg BID, valacyclovir 500mg QD and famciclovir 250mg one to two times a day; however, the length of prophylaxis has not been fully established. […] Most surgeons who perform a corneal graft in an eye with herpes simplex keratitis will continue their prophylaxis for many years, if not for life, declares Dr. Rapuano. […] HEDS demonstrated a 50% decrease in ocular herpes, not 100% elimination, Dr. Rapuano reminds.

• #79 Herpes Simplex Eye Infections: Symptoms and Treatment

  https://patient.info/doctor/herpes-simplex-eye-infections

  Patients with multiple episodes of epithelial or stromal disease may be considered for prophylactic oral antivirals (such as aciclovir 400 mg twice daily for a year). This has been shown to reduce incidence of recurrence of the disease during this time if this is not their first episode of HSV activation. […] There is also some limited evidence suggesting that oral aciclovir may help reduce the recurrence rate (and graft rejection rate) in corneal transplant patients.

• #80 How to Manage Ocular Herpes

  https://www.reviewofophthalmology.com/article/how-to-manage-ocular-herpes

  For people who have recurrent stromal keratitis, we recommend long-term steroid drops with either oral or topical antivirals to prophylax that. […] I prefer to add oral antivirals, as there could be some viral activity stimulating the immune response, but the role of oral antivirals in these cases is really prophylaxis against having recurrences. […] Many years ago, HEDS demonstrated that, if you treat patients with a history of stromal keratitis with a low prophylactic dose of oral acyclovir (400 mg twice daily), their chance of experiencing a recurrence decreased by around 40 percent. […] When HEDS was initiated in 1989, there was a lot of controversy about using steroids in patients with herpes. […] Patients with ocular herpes can also develop endotheliitis. […] Its generally treated with both oral acyclovir as well as topical steroids for the inflammation. […] Its really important to try to get them to re-epithelialize as quickly as possible. […] The question is whether theres a rationale for using prophylactic treatment to prevent recurrences of zoster, as is done with herpes simplex. […] Vaccination is the best way to prevent herpes zoster.

• #81 Herpes Simplex Uveitis – EyeWiki

  https://eyewiki.org/Herpes_Simplex_Uveitis

  There is no evidence of primary prevention strategies for HSV iritis or ocular HSV. […] Long term, low dose, systemic antiviral therapy may be beneficial for some patients, in order to decrease the frequency of recurrences of iritis. At present, controlled studies to show this are lacking. One might expect the HEDS study findings on prophylaxis may be generalizable to iritis, but this cannot be certain given the low number of strictly iritis patients. Oral doses for prophylaxis for ocular herpes simplex disease are acyclovir, 400 mg twice per day or valacyclovir, 500-1000 mg daily.

• #82 Herpes Helper

  https://www.reviewofoptometry.com/article/herpes-helper

  Having said that, when a patient on oral antiviral prophylaxis is either not responding to the antiviral medication or is getting frequent recurrences, the questions of compliance with medication use and of antiviral resistance should be considered. […] Resistance of the herpes simplex virus (HSV) to oral acyclovir is thought to be rather low, with reports of 0.6% in immunocompetent patients. […] However, in immunosuppressed patients, the resistance rate jumps anywhere from 3% to 6%. […] Dr. Rapuano advises, one can consider using high-dose IV acyclovir to overcome the resistance, but that can induce renal toxicity. […] Dr. Rapuano summarizes that resistance to the commonly used prophylactic antiviral medications for HSV keratitis is rare in immunocompetent patients, but not as rare in immunosuppressed patients, so antiviral resistance should be kept in mind when considering this population. […] High-dose IV acyclovir, IV foscarnet or IV cidofovir can be considered in severe cases.

• #83 Herpes Helper

  https://www.reviewofoptometry.com/article/herpes-helper

  Having said that, when a patient on oral antiviral prophylaxis is either not responding to the antiviral medication or is getting frequent recurrences, the questions of compliance with medication use and of antiviral resistance should be considered. […] Resistance of the herpes simplex virus (HSV) to oral acyclovir is thought to be rather low, with reports of 0.6% in immunocompetent patients. […] However, in immunosuppressed patients, the resistance rate jumps anywhere from 3% to 6%. […] Dr. Rapuano advises, one can consider using high-dose IV acyclovir to overcome the resistance, but that can induce renal toxicity. […] Dr. Rapuano summarizes that resistance to the commonly used prophylactic antiviral medications for HSV keratitis is rare in immunocompetent patients, but not as rare in immunosuppressed patients, so antiviral resistance should be kept in mind when considering this population. […] High-dose IV acyclovir, IV foscarnet or IV cidofovir can be considered in severe cases.

• #84 Herpes Helper

  https://www.reviewofoptometry.com/article/herpes-helper

  Having said that, when a patient on oral antiviral prophylaxis is either not responding to the antiviral medication or is getting frequent recurrences, the questions of compliance with medication use and of antiviral resistance should be considered. […] Resistance of the herpes simplex virus (HSV) to oral acyclovir is thought to be rather low, with reports of 0.6% in immunocompetent patients. […] However, in immunosuppressed patients, the resistance rate jumps anywhere from 3% to 6%. […] Dr. Rapuano advises, one can consider using high-dose IV acyclovir to overcome the resistance, but that can induce renal toxicity. […] Dr. Rapuano summarizes that resistance to the commonly used prophylactic antiviral medications for HSV keratitis is rare in immunocompetent patients, but not as rare in immunosuppressed patients, so antiviral resistance should be kept in mind when considering this population. […] High-dose IV acyclovir, IV foscarnet or IV cidofovir can be considered in severe cases.

• #85 Herpes Helper

  https://www.reviewofoptometry.com/article/herpes-helper

  Having said that, when a patient on oral antiviral prophylaxis is either not responding to the antiviral medication or is getting frequent recurrences, the questions of compliance with medication use and of antiviral resistance should be considered. […] Resistance of the herpes simplex virus (HSV) to oral acyclovir is thought to be rather low, with reports of 0.6% in immunocompetent patients. […] However, in immunosuppressed patients, the resistance rate jumps anywhere from 3% to 6%. […] Dr. Rapuano advises, one can consider using high-dose IV acyclovir to overcome the resistance, but that can induce renal toxicity. […] Dr. Rapuano summarizes that resistance to the commonly used prophylactic antiviral medications for HSV keratitis is rare in immunocompetent patients, but not as rare in immunosuppressed patients, so antiviral resistance should be kept in mind when considering this population. […] High-dose IV acyclovir, IV foscarnet or IV cidofovir can be considered in severe cases.

• #86 Herpes simplex infectionsExternal LinkExternal LinkExternal LinkExternal Link

  https://www.health.vic.gov.au/infectious-diseases/herpes-simplex-infections

  Health education and personal hygiene should be directed towards minimising transfer of infectious material and reducing the risk of exposure of high-risk groups. […] Emphasise personal hygiene to minimise the transfer of infectious material. Avoiding skin contact from the time of first symptoms (warning 'tingle’) on the mouth, genitals or anus, and for a week after the symptoms have gone helps prevent transmission. […] Wear gloves when in direct contact with infectious lesions, and wash hands with soap and water afterwards. […] Correct and consistent use of condoms during sexual intercourse decreases the risk of infection. […] Preventive antiviral medication (suppressive therapy) when recurrences are frequent can reduce the risk of transmission. […] Sun protection is important in preventing recurrences of facial herpes simplex. […] Patients with active lesions should have no contact with newborns, children with burns or eczema, or immunosuppressed patients. Consider caesarean section before the membranes rupture when primary or recurrent genital infections occur in late pregnancy, to minimise the risk of neonatal infection.

• #87 Eye herpes: Pictures, symptoms, and types

  https://www.medicalnewstoday.com/articles/321693

  As eye herpes can cause further infections, some doctors may recommend taking antiviral medicines regularly to reduce the risk of getting eye herpes again. […] Recurrent herpetic eye infections can lead to greater eye damage, which is why doctors aim to prevent their recurrence. Other prevention tips include: avoid touching the eyes, wash hands thoroughly, practice good hygiene, attend regular eye exams, use contact lenses as an eye doctor instructs.

• #88 Herpes Eye Disease in Children – Pediatric Eye Associates, LLC

  https://kideyedoc.com/herpes-eye-disease-in-children/

  Preventing herpes eye disease in children involves a combination of good hygiene practices, awareness, and minimizing the risk of exposure to the herpes simplex virus. Some examples of good practices include: […] Regular handwashing […] Avoid touching the face, especially when outside. […] Teach children not to share personal items like towels, washcloths, or tissues. […] Limit close contact during an outbreak. […] Encourage a healthy lifestyle, including proper nutrition, sufficient sleep, and stress management. […] Regular eye check-ups with a pediatric ophthalmologist or optometrist. This can help detect potential issues early on, allowing for timely intervention.

• #89 Herpes Eye Disease | Cedars-Sinai

  https://www.cedars-sinai.org/health-library/diseases-and-conditions/h/herpes-eye-disease.html

  There is not much you can do to prevent infection with HSV1. Your eye care provider may put you on an oral antiviral medicine to reduce your chance of having the virus reactivate. Staying away from too much sunshine and stress may also reduce your chances of reactivation. […] See your eye care provider at the first sign of symptoms. This can help reduce your chance of more complications.

• #90

  https://www.aao.org/eye-health/diseases/herpes-keratitis

  There is no complete cure for herpes; once the virus is in the body, you cannot get rid of it. However, if you develop herpes keratitis, there are some things you can do to help prevent recurring outbreaks: […] If you have an active cold sore or blister, avoid touching your eyes. […] When herpes eye infections happen often, your doctor might place you on a preventative antiviral medication that you take by mouth. […] Steroids can increase the herpes virus in the body. You should not use steroid eye drops unless you are taking an anti-viral medicine as well. […] Stop wearing contact lenses if you keep getting infections. […] See an ophthalmologist immediately if symptoms of ocular herpes return.

• #91 Eyes and Herpes: Q&A – Optometrists.org

  https://www.optometrists.org/general-practice-optometry/guide-to-eye-conditions/guide-to-corneal-diseases/can-herpes-affect-the-eyes/eyes-and-herpes-qa/

  Eye herpes, also known as herpes keratitis, is a viral infection of the eye caused by the herpes simplex virus (HSV). […] At the first sign of an outbreak, contact your doctor to begin treatment as soon as possible to reduce the possibility of vision loss. […] If you experience multiple flare-ups, your doctor may recommend taking a daily antiviral medication for prevention. […] A weakened immune system can also put you at increased risk of an eye herpes flare-up, and potentially lead to an outbreak. […] While most of these treatments are fairly short-term, you may also need to take antiviral oral medicine on a long-term basis. This is to help prevent future flare-ups.

• #92 Antiviral Therapy Associated with Fewer Recurring Eye Problems from Herpes Simplex Virus

  https://www.infectioncontroltoday.com/view/antiviral-therapy-associated-fewer-recurring-eye-problems-herpes-simplex-virus

  Taking oral antiviral medications following infection with the herpes simplex virus may be associated with a reduced risk of recurring eye-related manifestations of the disease, according to a report in the September issue of Archives of Ophthalmology. […] Patients not taking this prophylactic therapy were 9.4 times more likely to have a recurrence of epithelial keratitis, 8.4 times more likely to have a recurrence of stromal keratitis and 34.5 times more likely to have a recurrence of blepharitis or conjunctivitis than those taking antiviral medications. […] A total of 20 patients experienced adverse outcomes, including visual loss and perforation of the cornea; of these, 17 (85 percent) were not taking oral antiviral prophylaxis. […] „The results of this study suggest that oral antiviral prophylaxis should be considered for patients with frequent recurrences of corneal disease,” they conclude. „Additionally, we recommend an evaluation of the possible barriers preventing compliance with antiviral prophylaxis and a reassessment of the cost-effectiveness of long-term oral antiviral therapy.”

• #93 Prevention of Herpes Simplex Virus Induced Stromal Keratitis by a Glycoprotein B-Specific Monoclonal Antibody | PLOS One

  https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0116800

  Prevention of Herpes Simplex Virus Induced Stromal Keratitis by a Glycoprotein B-Specific Monoclonal Antibody […] The increasing incidence of acyclovir (ACV) and multidrug-resistant strains in patients with corneal HSV-1 infections leading to Herpetic Stromal Keratitis (HSK) is a major health problem in industrialized countries and often results in blindness. […] In conclusion, our data demonstrate that mAb 2c proved to be an excellent drug for the treatment of corneal HSV-infections and for prevention of HSK and blindness. […] Consequently, the objectives of the present study were to examine the neutralizing capacity of the HSV-gB-specific monoclonal antibody towards the eye-pathogenic HSV-1 strain KOS and ACV-resistant clinical isolates in vitro and its efficacy in prevention of HSK in the immunocompetent murine BALB/c model.

• #94

  https://link.springer.com/article/10.1007/s12250-014-3539-2

  Herpesviruses are a prominent cause of human viral disease, second only to the cold and influenza viruses. […] Unfortunately, no method currently exists to eradicate herpesviruses from the body after infection. […] Ultimately, the advent of effective vaccines will be crucial to preventing herpesvirus diseases altogether and cutting the incidence of ocular complications. […] Lairson D R, Begley C E, Reynolds T F, Wilhelmus K R. 2003. Prevention of herpes simplex virus eye disease: a cost-effectiveness analysis. Arch Ophthalmol, 121: 108112. […] Pepose J S, Keadle T L, Morrison L A. 2006. Ocular herpes simplex: changing epidemiology, emerging disease patterns, and the potential of vaccine prevention and therapy. Am J Ophthalmol, 141: 547557.

• #95 Prevention of Herpes Simplex Virus Induced Stromal Keratitis by a Glycoprotein B-Specific Monoclonal Antibody | PLOS One

  https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0116800

  Prevention of Herpes Simplex Virus Induced Stromal Keratitis by a Glycoprotein B-Specific Monoclonal Antibody […] The increasing incidence of acyclovir (ACV) and multidrug-resistant strains in patients with corneal HSV-1 infections leading to Herpetic Stromal Keratitis (HSK) is a major health problem in industrialized countries and often results in blindness. […] In conclusion, our data demonstrate that mAb 2c proved to be an excellent drug for the treatment of corneal HSV-infections and for prevention of HSK and blindness. […] Consequently, the objectives of the present study were to examine the neutralizing capacity of the HSV-gB-specific monoclonal antibody towards the eye-pathogenic HSV-1 strain KOS and ACV-resistant clinical isolates in vitro and its efficacy in prevention of HSK in the immunocompetent murine BALB/c model.

• #96 Prevention of Herpes Simplex Virus Induced Stromal Keratitis by a Glycoprotein B-Specific Monoclonal Antibody | PLOS One

  https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0116800

  Based on the unique properties of this antibody, we investigated the antiviral efficacy of topical or systemic mAb 2c treatment on the course of disease in BALB/c mice corneally infected with 1 105 PFU of HSV-1 KOS. […] In conclusion, these results demonstrate the successful prevention of HSV-mediated corneal disease by systemic mAb 2c application. There is also strong evidence that the topically applied antibody had no therapeutic effect. […] With regards to the future clinical application of the HSV-gB-specific monoclonal antibody in humans for the prevention of HSK, we subsequently investigated the protective effect of the humanized variant of this antibody (mAb hu2c) in corneally HSV-1 infected mice. […] Taken together, both the parental mouse antibody as well as its humanized variant showed equal protective effect on the development of HSK and blindness in a highly relevant mouse model.

• #97 Eye herpes: Pictures, symptoms, and types

  https://www.medicalnewstoday.com/articles/321693

  As eye herpes can cause further infections, some doctors may recommend taking antiviral medicines regularly to reduce the risk of getting eye herpes again. […] Recurrent herpetic eye infections can lead to greater eye damage, which is why doctors aim to prevent their recurrence. Other prevention tips include: avoid touching the eyes, wash hands thoroughly, practice good hygiene, attend regular eye exams, use contact lenses as an eye doctor instructs.

• #98 Herpes Simplex Keratitis – MD Searchlight

  https://mdsearchlight.com/infectious-disease/herpes-simplex-keratitis/

  Preventing Herpes Simplex Keratitis […] The herpes simplex virus is extremely common. People who have this virus should avoid close contact with others if they have recurring outbreaks of herpes simplex virus lesions on any part of their body. To help prevent spreading this virus to others, its crucial to maintain good hand and general hygiene. […] As much as possible, try not to touch your eyes with dirty hands, because this can spread the virus. Keeping hands clean through regular handwashing is important. If a person is infected, its best to keep them separate to reduce the risk of spreading the virus to people they live with or their other contacts. […] Once a person has been diagnosed with herpes simplex keratitis, an eye condition caused by the virus, its crucial for them to be aware of recurring outbreaks. Any delay in dealing with these recurrences could result in severe consequences. Therefore, its crucial that they seek medical attention promptly to ensure they receive the right care and treatment. Using preventive treatment might also be necessary to reduce the likelihood of future outbreaks.

• #99 Treatment for Herpes Eye Disease | UMass Memorial Health

  https://www.ummhealth.org/health-library/treatment-for-herpes-eye-disease

  Your healthcare provider may prescribe a medicine to decrease your chance of having the virus become active. […] You can also help reduce your chance of a flare-up. Avoid getting too much sunshine and limit your stress. […] Don’t touch your eyes or the area around them unless you have washed your hands well, especially if you have a cold sore or herpes blister. […] Wash your hands often with soap and clean, running water. […] Only use eye drops that have been prescribed or advised by your healthcare provider.

• #100 Herpes Simplex Virus (HSV) Infections – Infections – Merck Manual Consumer Version

  https://www.merckmanuals.com/home/infections/herpesvirus-infections/herpes-simplex-virus-hsv-infections

  People with HSV infection should avoid activities and other things known to trigger recurrences. For example, people with oral HSV infection triggered by sunlight should avoid exposure to sunlight as much as possible or use sunscreen when sunlight cannot be avoided. […] Because HSV infection is contagious, people with infection of the lips should avoid kissing as soon as they feel the first tingling (or, if no tingling is felt, when a blister appears) until the sore has completely healed. They should not share a drinking glass and, if possible, should not touch their lips. They should also avoid oral sex. […] People with genital herpes should use condoms at all times. Even when there are no visible blisters and no symptoms, the virus may be present on the genitals and can be spread to sex partners.

• #101 Herpes simplex eye infections

  https://www.nhs.uk/conditions/herpes-simplex-eye-infections/

  If treatment does not work or you keep getting the infections, your cornea (the transparent front part of your eye) might become scarred, causing sight loss. […] If you keep getting herpes simplex eye infections a doctor might recommend that you take antiviral tablets every day to help prevent infections. […] You’re unlikely to pass the virus on to someone else from an eye infection, but try to avoid touching your eye, and wash your hands regularly.

• #102 Treating HSV keratitis – EyeWorld

  https://www.eyeworld.org/2007/treating-hsv-keratitis/

  Patients with certain types of HSV are prone to recurrences. […] Some research, such as that from the HEDS investigators, indicates a role for oral antivirals to prevent these recurrences. […] Theres good evidence from the HED study that shows oral antiviral pills, such as the use of long-term acyclovir, can significantly reduce the risk for recurrences. […] The HEDS investigators found that long-term prophylaxis with oral antivirals can reduce recurrences by 50%. […] Dr. Chodosh recommends long-term oral acyclovir for patients with 1) multiple occurrences of HSV that each require corticosteroids, 2) recurrent inflammation with scarring or neovascularization that approaches the visual axis, 3) more than one episode of necrotizing keratitis, or 4) a history of herpetic eye disease and a corneal transplant. […] If patients with herpetic episodes must undergo eye surgery, Dr. Mah believes antiviral prophylaxis one day or a couple days before surgery, combined with post-op use for a couple of weeks, is another helpful measure.

• #103

  https://www.healio.com/news/optometry/20170713/clinicians-urge-prevention-and-early-aggressive-treatment-for-herpes

  Our experts stressed the significance of recognizing HZV early and initiating treatment as early as possible. […] One thing we need to do as eye doctors is realize how beneficial orals can be in many eye diseases we see, Autry said. […] In treating herpetic eye disease, it is often a fine balance between when to use and when not to use a topical steroid, she continued. […] Its wise to check creatinine levels prior to prescribing oral antivirals, he added. […] Caldwell explained that the Herpetic Eye Disease Study 2 [Wilhelmus KR et al.] taught clinicians that using a maintenance dose decreases the recurrence rate, but most patients refuse it even after the second or third episode. […] Don’t be afraid to treat this condition, Caldwell continued. We understand it better than ever, and the topical and oral medications today work well.

• #104 Understanding Herpes Keratitis: Causes, Symptoms, and Treatment – Burman & Zuckerbrod Ophthalmology Associates

  https://www.2020detroit.com/understanding-herpes-keratitis/

  While there is no cure for herpes keratitis, certain measures can help manage and reduce the risk of recurrence: […] Identifying and avoiding triggers, such as excessive sunlight or stress, can help prevent outbreaks. […] Maintaining good hygiene, including regular hand washing and avoiding touching the eyes, can reduce the risk of spreading the virus. […] Wearing sunglasses or other protective eyewear can help minimize exposure to sunlight, which can trigger the virus. […] Regular check-ups with an ophthalmologist can help monitor eye health and catch any potential issues early.

• #105 What You Should Know About Eye Herpes | Eye Vision Associates

  https://www.eyevisionassociates.com/what-you-should-know-about-eye-herpes-2021/

  Can Eye Herpes Be Prevented? […] While there is no foolproof way to prevent an eye herpes infection or any other type of eye infection, for that matter there are steps you can take to reduce your risk. […] The most important thing to remember is to keep your eyes and hands clean (which is all the more important if you have cold sores). Furthermore, it’s critical that you avoid touching your eyes if you or someone around you has an outbreak. […] If you wear contact lenses, be sure to follow your eye doctor’s instructions on contact lens care. Do not wear them longer than recommended and do not wear them while swimming, as chemicals and germs in the water can damage the lens, irritate your eyes, and cause an infection in contact lens wearers.

• #106

• #107 HSV Keratitis: An Important Infectious Cause of Blindness

  https://www.uspharmacist.com/article/hsv-keratitis-an-important-infectious-cause-of-blindness

  Ocular HSV can cause disease in any layer of the eye; most cases have been attributed to HSV-1.1,2 Common manifestations include follicular conjunctivitis, blepharitis, keratitis, and uveitis.2 […] While there are no proven methods for preventing HSV keratitis, there are steps that can be taken to assist in controlling its recurrences. Patients should be instructed to avoid touching the eyes or area around the eyes unless hands have been properly washed, particularly when a herpes infection (e.g., cold sore) is present. […] Habits, supplies, and techniques matter considerably when it comes to the health of the eyes while wearing contact lenses. Tips found in the Resource section can help pharmacists guide patients in the prevention of HSV recurrence by instructing those who wear contact lenses in the proper habits with regard to storage solution, cleaning technique, and replacement of lenses and storage cases. […] The caveat, according to Farooq and Shukla, is that primary exposure to HSV is not easily prevented; thus, developing improved treatments and a vaccine to prevent HSV keratitis are important.

• #108

  https://www.healio.com/news/optometry/20170713/clinicians-urge-prevention-and-early-aggressive-treatment-for-herpes

  Ocular herpes infections are presenting more often in the optometric practice, and experienced clinicians advocate for early detection and aggressive management. […] Most clinicians agree that an oral antiviral, such as Valtrex (valacyclovir, GlaxoSmithKline) or acyclovir is the best first-line option against an acute HSV dendritic keratitis. […] When that happens, go with an oral antiviral like Valtrex 1,000 mg three times daily for either simplex or zoster to reduce the viral load. Do not delay treatment due to availability; treat orally, as soon as possible. […] Oral antivirals are often sufficient to control the outbreak, PCON Editorial Board member Joseph P. Shovlin, OD, FAAO, said in an interview. […] He also suggests covering it prophylactically with Zirgan or Viroptic to make sure there is no rebound infection.

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