Herpes simplex virus, or HSV-1, is one of the most common viruses in the world. According to the World Health Organization, HSV-1 is so common that an estimated 3.7 billion people — or 66% of the world’s population — were living with this infection in 2016.

Type 1 herpes is usually acquired through oral-to-oral contact, and it’s the cause of cold sores. But HSV-1 can also be transmitted through sexual contact during oral sex, and rates of sexually-acquired HSV-1 have steadily increased in recent years. HSV-2, on the other hand, is transmitted through sexual contact and is responsible for most cases of genital herpes.

Herpes is a chronic infection, and although it can be managed, it can’t be completely cured. After the initial infection, recurring outbreaks can happen at different points in your life.

In addition to affecting your mouth and reproductive system, herpes can also affect your eyes. Keep reading this article to learn more about herpes viral eye infections.

Can herpes affect your eyes?

Yes. Most cases of herpes around the eyes are caused by HSV-1, although in rare cases, HSV-2 can also lead to eye infections.

The most common type of herpes eye infection is called epithelial keratitis or herpes simplex keratoconjunctivitis, a condition that affects the cornea — which is the clear front layer of your eyes. However, eye herpes can also affect other parts of the eye.

When herpes affects the stroma, which is the deeper layer of the cornea, the condition is called stromal keratitis. Stromal keratitis is more likely to cause long-term complications.

The risk of passing eye herpes to another person is extremely low, and it’s not considered to be an STD itself — instead, it’s a complication of an initial herpes infection.

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What causes herpes eye infections?

According to the NHS, the beginning of herpes in eye infections typically happens when a chronic herpes infection becomes reactivated and the virus spreads to the eyes. In many cases, the cause of an outbreak is unknown, but some the most common triggers for herpes outbreaks include:

Other illnesses
Fever
Eye injuries
Excessive stress
Immunosuppression
Exposure to intense sunlight
Dry, cold winds

Eyes herpes symptoms

According to the MSD Manual and Cedars-Sinai Hospital, the symptoms of symptoms of herpes in the eyes can include:

Eye pain
Increased tearing
Increased sensitivity to light
Eye redness
Headaches
Feeling like a foreign object is in your eye
Painful cold sore
Itchy eyes
Reduced vision
Swollen eyelids
Mucus discharge
“Crusty” eyes, similar to allergies

Eye herpes and styes can look similar. Additionally, you can experience symptoms of oral herpes and eye herpes simultaneously. For example, you may have cold sores around your mouth, and swollen eyelids or a fever blister under your eye at the same time. This can make it easier to diagnose eye herpes infections — keep in mind that the best way to diagnose herpes is by taking a swab of an active lesion.

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Complications of herpes around eyes

In most cases, herpes eye infections are self-limiting and will resolve on their own within a few weeks. The first time an infection occurs is known as primary herpes conjunctivitis or pink eye, a form of herpes that’s typically milder and indistinguishable from other types of conjunctivitis, and it usually resolves without causing any complications.

But if eye herpes becomes reactivated, it becomes more likely to cause scarring, swelling, and chronic vision problems. In rare cases, eye herpes can lead to permanent blindness. This risk increases with each recurrent reactivation of the disease.

Herpes conjunctivitis also increases your risk of developing secondary bacterial infections. This happens because the tissues in your eye become swollen, which creates tiny lesions that can become entry points for bacteria to enter the body.

Other complications of eyes herpes include:

Deep corneal ulcers
Permanent corneal scarring
Formation of abnormal blood vessels in the eye
Eye numbness
Glaucoma

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When to see a doctor

You should always seek medical attention if you’re showing signs of an eye infection and have recently had herpes. Any sign of an eye infection, even if your eye just feels sticky and blurry, should be taken seriously — after all, we can’t replace our vision so it’s very important to preserve it.

Your doctor will probably run different tests to diagnose eye herpes. They may examine your eyes using a slit lamp, using dye eye drops to allow them to spot any lesions. They may also take a swab or sample to perform a viral culture.

Herpes eye infection treatment

According to the American Academy of Ophthalmology, untreated herpes keratitis can severely damage your eyes, so it’s very important to get treatment for this disease as quickly as possible.

Herpes is a virus, which means that antibiotics aren’t effective against it. Instead, you’ll need to get treatment with antiviral medications. According to the Cleveland Clinic, herpetic eye disease can be treated using eye drops, oral medications, or both. Steroids can also be used to relieve swelling. Your doctor will recommend the right treatment for you based on your own personal history and the severity of your case.

You can learn more about herpes and other reproductive health topics at STDWatch.com.