OVERVIEW

What is herpes keratoconjunctivitis?

Herpes keratoconjunctivitis refers to damage to the cornea and conjunctiva caused by the herpes simplex virus. Main symptoms include eye pain, photophobia, tearing, and blurred vision. The condition is prone to recurrence and, in severe cases, may lead to blindness.

The herpes simplex virus is divided into two types: Type I primarily infects the mouth, lips, and eyes, while Type II mainly affects the genital organs. Herpes keratoconjunctivitis is mostly caused by Type I herpes simplex virus.

Is herpes keratoconjunctivitis common?

Yes, it is common. Herpetic keratitis caused by the herpes simplex virus ranks first in blindness rates among corneal diseases.

What are the types of herpes keratoconjunctivitis?

Herpetic keratitis caused by the herpes simplex virus can be divided into two types: primary and recurrent. Primary keratoconjunctivitis occurs during the first infection with the virus, mostly in infants and young children, while recurrent keratoconjunctivitis involves multiple episodes after the initial infection.

SYMPTOMS

What are the common manifestations of herpes keratoconjunctivitis?

Primary herpes keratoconjunctivitis is more common in infants and young children, presenting with fever, eye pain, herpes on the eyelids (yellowish-white translucent blisters), and swollen preauricular lymph nodes. Herpes may also appear on the lips or skin.

Recurrent herpes keratoconjunctivitis causes symptoms such as photophobia, tearing, and blepharospasm (persistent eyelid twitching). Some patients may experience blurred vision if the affected area is at or near the center of the cornea.

What severe consequences can herpes keratoconjunctivitis cause?

The most notable feature of this disease is its tendency to recur frequently. Since there are currently no effective medications to control recurrence, repeated episodes worsen corneal opacity, ultimately leading to blindness.

CAUSES

What is the cause of herpetic keratoconjunctivitis?

Herpetic keratoconjunctivitis is caused by infection with the herpes simplex virus.

How does herpetic keratoconjunctivitis specifically occur?

The vast majority of people have been infected with the herpes simplex virus in their lives, but symptoms do not necessarily appear immediately after infection. Sometimes the virus remains latent in the trigeminal nerve.

When the body's resistance declines, such as during a cold or fever, or with long-term use of glucocorticoids or immunosuppressants, the virus may reactivate. It then travels retrogradely along the nerves to the surface of the eyes or skin, causing herpes in the corresponding areas.

Who is most commonly affected by herpetic keratoconjunctivitis?

It is commonly seen in people with weakened immune systems, such as infants, young children, or those on long-term glucocorticoid or immunosuppressive therapy.

Is herpetic keratoconjunctivitis contagious?

The herpes simplex virus can spread between people. Some literature suggests that over 90% of adults carry the herpes virus and can transmit it to others or their offspring through saliva, childbirth, etc.

However, infection with the herpes simplex virus does not always lead to symptoms. In individuals with strong immunity, the virus may be controlled and remain latent in the nerve ganglia, only causing illness when immunity is compromised.

Is herpetic keratoconjunctivitis hereditary?

No.

DIAGNOSIS

How is herpes keratoconjunctivitis diagnosed?

First, the doctor will inquire about relevant medical history, such as whether the patient has recently experienced overexertion, corneal trauma, cold or fever, weakened immunity, or continuous corticosteroid treatment.

Then, based on corneal irritation symptoms—such as eye pain, photophobia, tearing, or eyelid spasms—or manifestations like follicular conjunctivitis, pseudomembranous conjunctivitis, or herpes on the eyelid skin, combined with certain tests, the doctor can confirm the diagnosis.

What tests are needed to diagnose herpes keratoconjunctivitis?

Corneal staining: A dye is applied to the damaged corneal surface to observe the shape and location of the lesions. If typical "dendritic" or "geographic" changes are found, it helps diagnose herpes keratoconjunctivitis.

Corneal scraping: Necrotic material is collected from the corneal lesion for culture to identify the pathogen type and its drug sensitivity. This aids in confirming the diagnosis of herpes keratoconjunctivitis and enables targeted treatment to improve cure rates.

Which diseases is herpes keratoconjunctivitis easily confused with?

It is often confused with the following two conditions:

• Epidemic keratoconjunctivitis: Can be distinguished by slit-lamp examination of the lesion site, corneal scraping to identify pathogen type, and testing the level of secretory IgA in the patient's tears.
• Corneal endotheliitis: Can be differentiated through slit-lamp examination of corneal endothelial cell structure and corneal scraping.

TREATMENT

Which department should I visit for herpes keratoconjunctivitis?

You should go to the ophthalmology department of a regular hospital. If the hospital has more specialized divisions, you can visit the corneal disease department.

Can herpes keratoconjunctivitis heal on its own?

Herpes simplex virus infection has a certain degree of self-limiting nature. Therefore, mild cases, especially first-time occurrences, may resolve on their own.

However, patients cannot determine whether it will heal without treatment. It is still recommended to seek medical attention at a regular hospital to avoid delays in treatment and serious consequences.

Does herpes keratoconjunctivitis require hospitalization?

If it is the patient's first episode with mild symptoms, good compliance, and the ability to adhere to regular follow-ups, medication can be prescribed for home treatment.

If the infection is deep or symptoms are severe, hospitalization is necessary for close monitoring and timely adjustment of treatment plans.

How is herpes keratoconjunctivitis treated?

Treatment mainly includes medication and surgery.

Common medications include ganciclovir (eye drops and ointment), acyclovir (eye drops and ointment), 1% trifluridine, and recombinant human interferon eye drops. Typically, eye drops are used during the day and ointment at night.

Surgery is suitable for patients with corneal perforation, and the procedure used is "penetrating keratoplasty."

What are the common side effects of medications for herpes keratoconjunctivitis?

Since the condition requires long-term and frequent eye drops, corneal toxicity must be monitored. To avoid this, obtain medications from a regular hospital and strictly follow medical instructions.

If new or unusual eye discomfort occurs during treatment, be alert to possible corneal toxicity and seek medical attention promptly.

What precautions and care are needed after surgical treatment for herpes keratoconjunctivitis?

Post-surgery, closely monitor the dressing. If yellow purulent or bloody discharge appears, notify medical staff immediately for examination.

Can herpes keratoconjunctivitis be completely cured?

First-time patients with mild symptoms can achieve full recovery without sequelae like corneal scars if treated promptly. However, the herpes simplex virus can remain latent in the body and may recur when immunity declines.

Does herpes keratoconjunctivitis require follow-up? How?

Follow up one week after discharge, then gradually extend the interval based on the condition.

DIET & LIFESTYLE

What should patients with herpetic keratoconjunctivitis pay attention to in their diet?

Focus on light, nutritious, and easily digestible foods, eat more fruits and vegetables, and maintain a balanced diet. Encourage consumption of foods rich in vitamin A, such as pork liver, carrots, and sweet potatoes. Avoid alcohol as much as possible.

What should patients with herpetic keratoconjunctivitis pay attention to in daily life?

Patients often experience pain and blurred vision, so family members should provide care to prevent collisions or falls. Use curtains to block strong light indoors and wear sunglasses when going outside.

Maintain eye hygiene. If there is excessive eye discharge, avoid wiping with towels or hands—use clean cotton swabs instead. Wash hands frequently and avoid touching the affected eye with dirty hands, water, or unclean items.

Does herpetic keratoconjunctivitis affect fertility?

No.

Can patients with herpetic keratoconjunctivitis fly, engage in strenuous exercise, or travel to high-altitude areas?

Frequent recurrences may impair vision and reduce the eye's resistance to external factors.

Therefore, it is not advisable to participate in strenuous activities, fly, or travel to high-altitude areas to avoid accidental eye injuries from impacts, pressure changes, or impaired vision that could endanger life.

How should family members care for patients with herpetic keratoconjunctivitis?

Since herpes simplex virus infections often recur when immunity is low, family members should encourage patients to improve their physical fitness and avoid overexertion or excessive emotional stress that may weaken immunity.

At the same time, family members should provide protection to prevent accidental injuries, ensure proper nutrition, and maintain a balanced diet to aid recovery.

The disease has a long course and is prone to recurrence, often causing irreversible vision damage after multiple episodes, leading to anxiety or pessimism. Family members should communicate patiently, offer encouragement, and maintain a positive attitude to help patients stay cooperative with examinations, treatment, and self-rehabilitation.

PREVENTION

Can herpes keratoconjunctivitis be prevented? How to prevent it?

The vast majority of people will be exposed to the herpes simplex virus in their lifetime, but it only causes noticeable illness when immunity is weakened. Therefore, improving the body's resistance is crucial to prevent the occurrence or recurrence of herpes keratoconjunctivitis.

In daily life, it is important to ensure adequate sleep, optimize dietary habits, actively participate in exercise to enhance physical fitness, and learn to manage stress effectively.