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Herpes Simplex Keratitis is an eye infection caused by the herpes simplex virus (HSV-1), the same virus responsible for cold sores. It affects the cornea, the clear front surface of the eye, leading to inflammation, redness, pain, blurred vision, and light sensitivity.
Once the virus enters the eye, it can remain dormant in the nerves and reactivate later, especially during times of stress, illness, or weakened immunity. While mild cases may cause surface irritation, more severe infections can damage deeper layers of the cornea, making early diagnosis and prompt treatment vital to preserving vision.
Diagnosing Herpes Simplex Keratitis begins with a detailed eye examination using a slit-lamp microscope to inspect the corneal surface. Ophthalmologists may apply a fluorescein dye to highlight any branching ulcers or scarring typical of viral infection. In some cases, laboratory swabs are taken to confirm the presence of the herpes virus.
Treatment depends on the depth and severity of infection. Antiviral eye drops or ointments are commonly prescribed to control the virus, while oral antiviral tablets may be added for deeper or recurrent cases. Steroid drops are sometimes used under close supervision to reduce inflammation and prevent scarring. Regular follow-ups are essential to monitor healing and avoid complications that can threaten long-term vision.
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Herpes Simplex Keratitis can appear suddenly and may resemble other types of eye irritation at first. Recognising the early warning signs is key to preventing deeper infection or permanent scarring of the cornea.
Even a minor infection or inflammation of the cornea can quickly become serious if left untreated. The table below outlines common presentations of Herpes Simplex Keratitis, related corneal conditions, and when urgent care is required. It helps you recognise key warning signs, understand likely causes, and see the safest next steps to protect your vision and prevent long-term damage.
Use this quick guide to identify viral and inflammatory causes of corneal irritation, their urgency, and the safest treatment steps. Early antiviral therapy can prevent scarring and long-term vision loss.
Herpes Simplex Keratitis can sound worrying, especially when symptoms flare suddenly or keep coming back. With the right specialist care, most episodes are treatable and your vision can be well protected. These FAQs answer the key questions patients in London often ask about causes, treatment, and long-term management.
The herpes virus itself is contagious (commonly spread through skin or oral contact), but simply being near someone with Herpes Simplex Keratitis does not put you at high risk of “catching” their eye infection. Good hygiene and avoiding sharing towels, eye drops, or makeup is important.
Flare-ups can be triggered by stress, illness, fatigue, strong sunlight/UV exposure, eye injury, or using steroid drops without antiviral cover. Some people never have a second episode; others experience occasional recurrences.
Treatment usually includes antiviral eye drops or ointment, sometimes combined with oral antivirals. In deeper or inflammatory cases, carefully supervised steroid drops may be used to limit scarring. It’s essential not to self-start steroid drops.
Most mild infections heal well with early treatment. Repeated or severe episodes can cause corneal scarring, thinning, or irregularity that may affect clarity. Regular monitoring and prompt treatment significantly reduce this risk.
You should avoid contact lenses during any active infection. Once fully healed, some people can safely return to lenses under specialist guidance, but many are advised to limit or stop lens wear to reduce irritation and recurrence.
Protect your eyes from UV with good sunglasses, avoid over-wearing contact lenses, manage stress where possible, and never use steroid eye drops without medical advice. In frequent recurrences, your specialist may recommend long-term low-dose oral antivirals.
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Consultant Ophthalmologist
Consultant and Surgeon
