Ocular HSV

[Nurseynurse714]

Hi Doc,thanks for taking the time to read my post.I am a 30-something HSV positive female, no PMH otherwise.2 mos ago, developed severe eye burning, bumpy rash above R. eye on forehead and also on R. eyelid, conjunctivitis which appeared to be bilateral.PCP glanced my direction for a fleeting moment and sent me out w/Tobradex gtts for 4 dys.Sx persisted with intermittent stabbing pains behind eyes,dull throbbing pain.Back to pcp 3-4 more times: then the dx was eye allergies&"reactive" skin above the eye- sent out w/ multiple allergy eye gtts,high dose steroids for the rash,claritin.None of the above worked.Sx persisted & finally got pcp to send me to ophthalmologist.Have seen the initial ophthalmologist & his partner(2 total visits with thorough eye exams/slit lamp, etc)since then and both say no lesions,no s/s HSV,no s/s inflammation,only lack of tear production-drops provided.Rash persists intermittently and seems to "calm" with Valtrex and flare prior to menstruation.Rash also now on chin. They have me @ 20/20,but I swear I am losing "sharpness" of my vision,particularly in dim light. W/normal eye exams,could this still be HSV? Please help. Thank you again.

[Nurseynurse714]

Hi Doc,

Me again- so sorry to keep asking more info, but I AM having decreased visual acuity in both eyes and have seen 2 ophthalmologists both of whom can find nothing abnormal. Rash has since spread on my face and derm insists not herpes b/c no blisters. Where do I go from here? What else besides dendritic lesions or corneal ulcers should they be looking for? Sorry again to keep begging your assistance, but I'm terrified I'm going to end up blind. As mentioned, I don't even get full blown blisters when I get my cold sores, just the burning tingly thing. What should I do? I'm so scared......

[Ag-i-doc]

you dont have keratitis.  but HSV keratitis symptoms are exactly the same as the symptoms of every "red eye":

pain, watering, redness, light sensitivity, blur, etc etc.

[Nurseynurse714]

Hi Doc,

Thanks for the prompt reply. Can you please clarify what exactly are the symptoms of HSV keratitis and how dangerous is it? Can it result in blindness? Thanks again for all of your help.

[Nurseynurse714]

Hi Doc,

[Ag-i-doc]

there is no one symptom that is diagnostic of HVS keratitis that would distinguish it from any other red eye.

there are SIGNS that would distinguish it from other red eyes, but you'd have to pretty much be an eye doctor, and have the right equipment (slit lamp), *and* know what you're looking for.  and even then its tough.

[Ag-i-doc]

i'm sorry, i didnt answer all of your questions.  can it cause blindness?  sometimes it causes some pretty good scarring, which could result in poor acuity...so yes, it can cause blindness.

but USUALLY NOT.

[Forum-OD-MP]

yes, could still be HSV.

simplex keratitis is very painful however.  plus the ophthal. would not have missed a raging keratitis, so i doubt that is what is causing you to feel like you are losing sharpness.

there's no real fix for HSV/HSV keratitis anyway...its usually recurrent, treatment varies, many different opinions on how & what to do for it.