Eye Herpes - Causes, Symptoms and Treatment .MF .
Herpetic infection can affect all organs and systems, including the eyes.The most common disease - shingles, skin lesions eyelids, conjunctivitis, keratitis, an inflammation of the choroid (iridocyclitis and chorioretinitis), optic neuritis, herpetic retinopathy, acute necrosis of the retina.All of these diseases have in most cases, chronic and often lead to complications.
reasons herpetic lesions
Eye By the time of occurrence of herpes can be acquired and congenital.Herpes is caused by a virus 1, type 2 and Varicella Zoster.Contributing factors:
- related serious diseases that reduce immunity, including infectious
- prolonged use of antibiotics
Herpetic infection - vysokozaraznoe disease.Ways of transmission: airborne, contact, sex, upward (from other agencies), transplacental.
symptoms of herpes in front
Shingles with manifestations in front when there is involvement in the inflammatory process of the first branch of the trigemin
affected skin of the upper eyelid and eyebrow area, rarely the lower eyelid (with the defeat of two nerve branches).Increases and becomes painful regional lymph nodes.If the process involves the nervus nasociliaris, the characteristic rash appears at the inner corner of the eye and the cornea.Almost always, the virus affects one half of the face.
Symptoms of herpes
eyes If the skin herpes century marked a strong itching and burning on congested (reddened) skin appear bubbles, their contents become cloudy, and then formed a crust.When combing the scars remain.
There are 3 forms of herpetic conjunctivitis: follicular, catarrhal and vesicular-ulcerative .
first type is sluggish flow, characterized by redness of the eyes and blurred scant mucous discharge.Characteristic symptoms are not present.
When catarrhal form complaints are more pronounced, is keen for.
Classic manifestations vesicular herpetic conjunctivitis - precipitation in the form of bubbles, the formation of crusts without scarring.
vesicular form of viral conjunctivitis
Keratitis , caused by the herpes virus, is divided into the tree, the edge, the erosion of the cornea, discoid, bullous, metagerpetichesky.Symptoms of all similar.They are characterized by blepharospasm (you can not open your eyes), photophobia, and lacrimation, pain.Corneal sensitivity decreases, which may lead to accidental injury and infection secondary connection.On the cornea appear rash and infiltrates.The most pathognomonic herpetic keratitis - tree.In this case bubbles appear along the nerve fibers of the cornea.Bursting, they cause pain.
keratitis caused by herpes virus
discoid keratitis refers to the deep.There is a circular corneal stromal haze.Perhaps the appearance of wrinkles Descemet's membrane and precipitates on the endothelium.Often it goes to iridocyclitis.The forecast is unfavorable, sinceoften remain corneal opacities.
Deep keratitis are keratouveitis .In these cases, the symptoms of corneal inflammation symptoms joins iridocyclitis.
Iridocyclitis , caused by the herpes virus can occur in acute, subacute and indolent form.By the nature of the process is serous and seroplastic.Characterized by pain in acute and subacute, perikornealnaya conjunctival injection, greasy precipitates on the corneal endothelium, the moisture anterior chamber opalescent (if joined secondary flora, the hypopyon), possible hyphema (red blood cells in the moisture anterior chamber), rear adhesions (the pupil does not expand or hasirregular shape), the formation of adhesions between the iris and the lens or at the corner of the anterior chamber (intraocular pressure increases, respectively).Iris becomes a full-blooded, edematous, its image is flattened.
Acute retinal necrosis - a type of chorioretinitis, is considered a possible cause of the herpes virus.It occurs more often in people with immunodeficiency (eg HIV infection).Symptoms: loss of vision, if in the process involved the central region.One eye is affected, and in a few months and the second.Inflammatory lesions appear first on the periphery, then they merge, and this can lead to exudative retinal detachment.Occurrence of infiltration in the vitreous.Strands may be formed later, leading to traction retinal detachment.More than half of people with acute retinal necrosis, blinded.
Other eye diseases do not have specific manifestations of herpes infection.The presence of virus detected only at inspection.
diagnosis of herpes virus
For diagnosis needed:
- by external examination of the face and eyelid skin may be a characteristic rash,
- visometry - vision can be dramatically reduced in the presence of infiltration of the cornea, chorioretinitis and optic neuritis,
- analgizemetriya - with herpetic infection of corneal sensitivity decreased,
- biomicroscopy, including after staining with fluorescein,
- examination in transmitted light to determine the transparency of the eye media,
- ophthalmoscopy and examination with Goldmann lens to identify foci of infectionthe fundus.
In most cases, the symptoms are not specific for herpes, so without laboratory confirmation of the diagnosis is not possible.One of the diagnostic methods - determination of antibodies to the virus in conjunctival scrapings from the fluorescent antibody technique.In general, the analysis of the blood increased levels of white blood cells and lymphocytes (immune deficiency if there is, it is reduced), during primary infection is carried intradermal allergy tests.Examine the condition of the immune status for the proper purpose of immunomodulators.In smears from the cornea and conjunctiva by PCR can identify DNA of the virus.
surest method of diagnosis - Virology (virus is grown in eggs or special nutrient media) - but it is very costly and time (up to 3 weeks), so often used for scientific purposes, and not for the purpose of treatment.
also detect antibodies to herpes blood.Elevated levels of IgG indicates prior infection.If you detect IgM, then the process is acute.They appear at 5-7 days of disease, so has no meaning previously examined for antibodies (e.g. ELISA - enzyme-linked immunosorbent assay).
mandatory consultation dermatologist, infectious disease specialist, a neurologist.
Eye Treatment Herpes Treatment
necessarily carried out under the supervision of an ophthalmologist.If it affects the skin of the face and eyelids bubbles smeared ointment acyclovir 3% 4 times a day to 2 weeks.For the drying of inflammatory cells can be used topically dyes (brilliant green solution, a solution of iodine, fukortsin).
in the conjunctival sac bury Oftan-IMU 4 times a day for 10 days to prevent the spread of infection.
When herpes zoster, and severe pain do procaine blockade, as well as taking into antiherpethetical preparations for the week (Acyclovir 5 times a day to 0.2 grams, 0.5 grams of Valacyclovir for 2 times a day).To speed up the healing topically applied physiotherapy treatments (UHF, UFO).
When herpetic conjunctivitis prescribe the following drugs:
- antiviral drops and ointments - Oftan IMU-1 drop 6 times a day, Okoferon 1 drop 6 times a day, acyclovir ointment 3% 2-3 times a day
- antisepticdrops - Miramistin, Okomistin 1 drop 6 times a day
- anti-inflammatory drops - Indokollir, Naklof, Diklof 1 drop 3 times a day
- antibacterial drops when joining secondary bacterial flora (Floksal, Tobrex, Oftakviks 1 drop up to 6 timesper day)
- antihistamine drops - cromolyn sodium or Opatanol 1 drop 3 times a day with the appearance of allergic reactions.
Treatment long, at least 3-4 weeks under the supervision of an ophthalmologist .
herpes complications on eyes:
spread of infection (keratitis), and allergic reactions.
Herpetic keratitis - the most common viral infection of the eye.Treatment of the complex and is carried out in a hospital environment.Approximate treatment regimen: instilled into the affected eye 6 times a day 1 drop Oftan-IMU Okoferon, Okomistin, Floksal;3 times per day Indokollir Acyclovir ointment and 3%.With deep keratitis midriatiki prescribed for prevention of adhesions (Tropikamid, Midriatsil 2-3 times a day).If the corneal epithelium is intact, then use hormonal drops and ointment (hydrocortisone ointment 1%, 0.1% dexamethasone drops 2-3 times a day).Some drugs are best administered subkonyunktivalno parabulbarno or, for example, interferon, phenylephrine, dexamethasone, antibiotics.Topical treatments with total combined therapy: antiviral (acyclovir 0.2 g 5 times a day), vitamin (ascorbic acid, vitamin B).Also shown are inducers of interferon, for example, according to the scheme or TSikloferon Amizon.If necessary, an immunologist appoints immunomodulators.Physical therapy accelerates the healing process: UHF, UFO, magnetic therapy, laser therapy, phonophoresis.
If conservative treatment is ineffective, use cryotherapy or laser coagulation of inflammatory foci.Complications keratitis: uveitis, allergic reactions, corneal opacity down to cataracts.
treatment of herpetic uveitis (iridocyclitis and chorioretinitis) require intravenous acyclovir at a dosage of 5-10 mg / kg every 8 hours may intravitreal administration of valacyclovir or famciclovir.In severe cases, the proliferative changes in the vitreous and retinal detachment risk of operative treatment - laser photocoagulation and vitrectomy the retina affected areas.Complications: loss of vision, retinal detachment.
Herpes Prevention Herpes
struck 95% of the total population.The virus lives in the body and can not express themselves, but relapses occur under unfavorable conditions.Therefore, prevention is to strengthen the immune system, timely and comprehensive treatment of exacerbations, good nutrition and a healthy lifestyle, vaccination in remission.
Ophthalmologist Letyuk TZ