ocular herpes


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Related to ocular herpes: conjunctivitis, Graves disease, Orbital cellulitis

ocular herpes

Etymology: L, oculus, eye; Gk, herpein, to creep
a herpesvirus infection of the eye. See also herpes simplex keratitis, herpes zoster ophthalmicus.
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Ocular herpes

ocular herpes

Herpes simplex that extends to the eyes.

Clinical findings
Usually unilateral, affects the cornea (herpes keratitis) and, if it remains superficial, heals without scarring. Infections involving the deeper cornea result in scarring, loss of vision and, in extreme cases, blindness.

herpes

(her'pez? ) [Gr. herpes, creeping]
Vesicular eruption caused by a virus, esp. herpes simplex virus or herpes zoster.

herpes corneae

Inflammation of the cornea caused by herpesvirus.

herpes facialis

A form of herpes simplex that occurs on the face.

herpes febrilis

Herpes simplex of the lips and nasal mucosa.
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GENITAL HERPES
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GENITAL HERPES

genital herpes

A persistent, recurring eruption of the genital or anorectal skin or mucous membranes, caused by herpes simplex virus (usually herpes simplex virus type II). It usually affects adolescents and young adults, is spread by intimate contact, and is classified as a sexually transmitted disease. Worldwide about 85 to 90 million people are infected. See: illustration

Symptoms

Patients often experience local pain, itching, burning, dysuria, or other uncomfortable sensations that sometimes begin before a rash or lesion(s) appears on the skin. The skin lesion consists of a reddened patch or small blisters (vesicles) or pustules that ulcerate before healing. These typically take about 10 days to heal. Regional lymph nodes often enlarge and become tender. Systemic symptoms (e.g., fever and malaise) sometimes accompany the initial outbreak or recurrences. However, asymptomatic shedding of the virus is common and may represent the most common way in which the virus is transmitted from person to person.

Potential Complications

Genital herpes may be transmitted to the newborn during childbirth and may cause serious complications, including respiratory illnesses, retinal infection, liver infection, encephalitis, mental retardation, blindness, deafness, seizures, microcephaly, and diabetes insipidus. Cesarean delivery or maternal suppression of the virus with acyclovir are two methods used to prevent newborn infection. Poor hand hygiene may transmit the virus to the eye(s), resulting in herpetic keratoconjunctivitis.

Treatment

Oral acyclovir or its derivatives can treat both the initial outbreak and subsequent recurrences and diminish asymptomatic viral shedding.

CAUTION!

Herpetic lesions are contagious, and those caring for the patient must avoid contact with the exudates. Wearing gloves when in contact with mucous membranes, followed by good hand hygiene helps health care professionals prevent herpetic whitlow (finger infections).

Patient care

The patient should be taught to avoid all skin-to-skin contact when lesions are present and to practice safe sex. Patients should not share towels or other personal care items. Patients with genital herpes often experience anger, self-doubt, fear, or guilt, esp. at the time of initial diagnosis or during recurrences. Counseling and support may help the patient address these issues. Patient education improves understanding of the prevalence of the disease in the general population, the recurring nature of the eruption, safe sexual practices, medication use, and psychosocial and relationship issues.

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herpes gestationis

An autoimmune rash usually occurring in pregnancy or trophoblastic disease, characterized by red, itchy, blistering, or papular lesions. The lesions stain positive for the third component of complement on immunofluorescent microscopy.
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HERPES LABIALIS

herpes labialis

A form of herpes simplex that occurs on the lips.
See: cold sore; fever blister; illustrationillustration

herpes menstrualis

Herpetic lesions appearing at the time of the menstrual period.

ocular herpes

Herpes of the eye.

herpes simplex

An acute infection caused by herpes simplex viruses 1 and 2. The infections are categorized by the site of infection, e.g., herpes corneae, herpes facialis, genital herpes, etc.
See: herpes simplex virus under virus.

traumatic herpes

Herpes at a wound site.
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HERPES ZOSTER
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HERPES ZOSTER

herpes zoster

Reactivation of varicella virus years after the initial infection with chickenpox. It is marked by inflammation of the posterior root ganglia of only a few segments of the spinal or cranial peripheral nerves. A painful vesicular eruption occurs along the course of the nerve (called a dermatome) and almost always is unilateral. The trunk is the region most often affected, but the face, the groin, or the limbs may also be affected. The virus may cause meningitis or affect the optic nerve or hearing. Chickenpox (varicella zoster) virus incorporates itself into nerve cells and lies dormant there after patients recover from the initial infection. Normally, immunity is boosted by exposure to infected children; as more children are vaccinated against chickenpox, adult immunity against herpes zoster is decreased.

The incubation period is from 7 to 21 days. The total duration of the disease from onset to complete recovery varies from 10 days to 5 weeks. If all the vesicles appear within 24 hr, the total duration is usually short. In general, the disease lasts longer in adults than in children. It is estimated that about 50% of people who live to age 80 will have an attack of herpes zoster. This infection is more common in persons with a compromised immune system: older adults, those with AIDS or illnesses such as Hodgkin's disease and diabetes, those taking corticosteroids, or those undergoing cancer chemotherapy.

Pain often develops along affected skin and persists for months after resolution of the rash. This discomfort, which may be severe in patients older than 50, is known as postherpetic neuralgia. It may intensify at night or worsen when clothes rub against the skin. Synonym: shinglesillustration; herpes zoster ophthalmicus;

Diagnosis

Diagnosis is usually made based on clinical assessment. If further studies are required, the CDC recommends direct fluorescent antibody testing of specimens collected by rubbing a swab on the base of an open lesion.

Treatment

In healthy adults, acyclovir, famciclovir, and valacyclovir are effective in reducing viral shedding and nerve pain damage if administered within 3 days of onset of the rash. Corticosteroids, gabapentin, pregabalin, nonsteroidal anti-inflammatory drugs, some antidepressants, and narcotics may decrease the pain of postherpetic neuralgia. Itching may be reduced with colloidal oatmeal or other topical treatments. Capsaicin cream (an extract of hot chili peppers) may be applied topically for pain relief, but this should be done only after active lesions have subsided.

Patient care

The prescribed antiviral agent is administered and explained to the patient, along with information about desired and adverse effects. Skin lesions are inspected daily for signs of healing or secondary infection; the patient's response to treatment is evaluated regularly, and he is monitored for associated complications. Prescribed analgesics are given on a schedule to minimize neuralgic pain. Patients experiencing neuralgia following the acute stage of the disease should be referred for ongoing therapy. He is reassured that HSV pain will subside eventually, that the prognosis for complete recovery is good, and that the infection seldom recurs.

prevention

Reactivation of varicella zoster virus (VZV) may be prevented with a vaccine. VZV vaccination is approved for use in the U.S. in adults at age 60.

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HERPES ZOSTER OPHTHALMICUS

herpes zoster ophthalmicus

Herpes zoster affecting the first division of the fifth cranial nerve. The area of the face, eye, and nose supplied by this nerve is affected. Ocular complications may threaten sight. It is important that the eye be treated early with antiviral agents and that therapy be supervised by an ophthalmologist.
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herpes zoster oticus

Ramsay Hunt syndrome.

ocular herpes (ok´ūlur),

n HSV-1 or HSV-2 infection of the eye, resulting in lesions on the eye. The infection can be transmitted by contaminated saliva contacting the eye.
References in periodicals archive ?
The revenue is associated primarily with R&D collaboration revenue from AT-006, the antiviral for treatment of ocular lesions associated with feline ocular herpes infection and the recognition of license and collaboration fees related to its AT-004, B-cell monoclonal antibody for lymphoma.
CTC-96 has successfully completed randomized double-blinded Phase I trials for the treatment of adenovirus keratoconjunctivitis and for the treatment of ocular herpes infection, a leading cause of persistent corneal disease in the developed world.
Each year, ocular herpes simplex virus is estimated to affect approximately 50,000 people in the United States, arising as acute primary disease in 20,000 people and as recurrent disease in an additional 28,000.
wide range of topics from ocular herpes, a common cause of blindness