Basics of HSV (Herpes Simplex Virus) Keratitis

HSV (Herpes Simplex Virus) keratitis is an infection of the cornea—the clear dome that covers the colored part of the eye—that is caused by HSV. The infection usually heals without damaging the eye, but more severe infections can lead to scarring of the cornea or blindness. HSV keratitis is a major cause of blindness worldwide 1. HSV-1, which is the type of HSV that also causes cold sores on the mouth, is the most common cause of corneal infections.

Symptoms of HSV keratitis include 2:

  • Eye pain
  • Eye redness
  • Blurred vision
  • Sensitivity to light
  • Watery discharge

If you experience any of these symptoms, remove your contact lenses (if you wear them) and call your eye doctor right away. If left untreated, HSV keratitis can result in vision loss or blindness.

HSV is only found in humans and is spread through direct contact with someone who is infected with the virus 3. Most HSV keratitis infections happen after another part of the body—most commonly the mouth 4—has already been infected by HSV 5. HSV keratitis is often the result of a “flare up” (reactivation) of the earlier infection.

People who have had HSV keratitis are at risk for recurrences of the same infection 2. For these people, wearing contact lenses may further increase the risk 6.

People most at risk for HSV-1 (but not necessarily HSV keratitis) are 7:

  • Female
  • Non-Hispanic black or Mexican American
  • Born outside the United States
  • Sexually active, or have had 3 or more lifetime sex partners

HSV keratitis is usually diagnosed based on a patient’s health history and findings from an eye exam. Lab testing is not usually necessary, but certain lab tests may further help to confirm HSV-1.

The treatment of HSV keratitis usually involves medicine, including eye drops or antiviral medications taken by mouth 4. Surgery is rarely necessary but may be considered if scarring on the eye from HSV keratitis causes vision problems. Each case of HSV keratitis is unique, and an eye doctor should determine the best treatment for each patient. While some treatments can greatly lower the severity and recurrence of symptoms, there is no cure for HSV.

Currently there are no proven methods for preventing HSV keratitis, but some steps available from the Mayo ClinicExternal may help to control HSV keratitis recurrences:

  • Avoid touching your eyes or the area around your eyes unless you have washed your hands properly—especially if you have a cold sore or herpes blister.
  • Only use eye drops that have been prescribed or recommended by an eye doctor or health care provider 8.

Follow these tips to keep your eyes healthy while wearing contact lenses. Your daily habits, your contact lenses and supplies, and your eye doctor are all important.

  1. Liesegang TJ. Herpes simplex virus epidemiology and ocular importanceExternal. Cornea. 2001;20(1):1-13.
  2. Welder JD, Kitzmann AS, Wagoner MD. Herpes Simplex Keratitis.External
  3. Pepose JS, Keadle TL, Morrison LA. Ocular herpes simplex: changing epidemiology, emerging disease patterns, and the potential of vaccine prevention and therapyExternal. Am J Ophthalmol. 2006;141(3):547-57.
  4. Kaye S, Choudhary A. Herpes simplex keratitisExternal. Prog Retin Eye Res. 2006;25(4):355-80.
  5. Kennedy DP, Clement C, Arceneaux RL, Bhattacharjee PS, Huq TS, Hill JM. Ocular herpes simplex virus type 1: is the cornea a reservoir for viral latency or a fast pit stop?External Cornea. 2011;30(3):251-9.
  6. Mucci JJ, Utz VM, Galor A, Feuer W, Jeng BH. Recurrence rates of herpes simplex virus keratitis in contact lens and non-contact lens wearersExternal. Eye Contact Lens. 2009;35(4):185-7.
  7. Bradley H, Markowitz LE, Gibson T, McQuillan GM. Seroprevalence of Herpes Simplex Virus Types 1 and 2–United States, 1999-2010External. J Infect Dis. 2013.
  8. Mayo Clinic. Keratitis.External Diseases and conditions 2012.
Page last reviewed: April 7, 2014