Eyelid inflammation caused by a virus?

[Syagrius]

Hi,

It has been one month since I have a sensation of burning, tearing and foreign body around my eye (in the eyelid). Sometimes it is more painful than others. I have sometime a rash sensation. It is only hapenning in my left eye. I went to the hospital and they say there is no infection in my eye and no foreign bodies have been found in the eye. They used a small colored liquid to do that.

The symptoms started in march 30. Two days before, my girlfriend kissed me in the corner of the eye, precisely where 48 hours later it all started. My girlfriend is pregnant and has not a strong immune system. So, since she is pregnant, she frequently has outbreaks of herpes simplex virus 1. I don't remember is she had one, but I read the the saliva can propagate the virus.

So my question is, could the symptoms of ocular herpes limit themselves to a pain around the eye. Should an ophtalmologist do a culture of my tissues around the eye to check for viral infection? I have read that a first infection can be asymptomatic for herpes 1 innoculation. In order words, how can I be sure of what it is? I have an appointment in an external clinic of ophtalmology in may 7. Should I insist for a tissue culture? I have read that if it is left untreated, it could lead to cornea scarring and damage the eye. So I must be sure it is or not that virus.

I thank you in advance for your answers?

Syagrius

[John C Hagan III, MD, FACS]

Your question has been answered by 'circumspect' a member of the American Academy of Ophthalmology.

[Syagrius]

Finally, the ophthalmologist I consulted diagnosed angular blepharitis on both eyes just by checking my eyelids. He gave me tobradex and told me to clean my eyelids, put a lubrifiant if necessary, and put warm compresses.

I checked over the Internet and saw that it could be either bacterial or viral for the source of this disorder. I asked him how he could tell it was not viral, since I told him the coincidence of when the symptoms started (girlfriend kissing me there two days before it started). His answer was not clear. Maybe he assumed that the eyes themselves were clean, so it couldn't be a virus.

I found a website which describe a recurrent angular blepharitis caused by HSV-1 without symptoms on the eye itself. It left me thoughtful. It is surely more fears than true danger, but it left me wondering if the ophthalmologist couldn't have done a cells culture just to check if it was bacterial or viral. If it is viral, I can be sure to have problems again in the comming month as it will reoccur.

Here's the website I talked about :

http://www.springerlink.com/content/vyrgl4yk64kepl24/

Does anyone know what I should do?

Syagrius

[Syagrius]

It is angular blepharitis said the ophthalmologist I saw. He gave me tobradex to combat any infection, but it does not relieve me from the pain. The upper left of the eyelids of my left eye hurts deep into my skull. It is hard to handle it on a daily basis. I hope not to be stuck with that pain for the rest of my life.

If tobradex does not help, is it because it could be something else than a bactery. What should I do?

Syagrius

[circumspect]

I am a board certified ophthalmologist and am answering questions until the new ophthalmology forum is up and running.

Your symptoms do not suggest that your symptoms are due to herpes simplex virus (HSV) type 1. Bacterial, viral and tissue cultures are very expensive and because of the time it takes to get the results back are often neither timely or useful to the ophthalmologist. Your EyeMD has done you a good turn by using their clinical skills and foregoing these unnecessary tests.

Angular blepharitis or angular blepharo-conjunctivitis is not a serious problem. If it does not clear up or re-occurs you should see the ophthalmologist for a follow-up examination.

I'm sure you have read the prescribing information on Tobradex. It is a combination of an antibiotic (tobramycin) and a steroid (dexamehtasone). It is not for long-term use unless you are monitored by the EyeMD. Nor should it be used for other conditions of the eye unless you see the doctor for a biomicroscopic (slit-lamp) examination. There are some conditions that cause a red eye (example HSV keratitis) that the steroid could make worse.

I'm glad your problem did not turn out to be HSV.

JCH MD Board Certified Ophthalmologist

[Syagrius]

I thank you for your reply. Effectively, I am glad it is not SHV. It would be a huge problem then.

Actually my symptoms have dimished. I still feel a small pain inside my skull in the upper left of my left eye and I also feel headaches in this region of my head. But it is more bearable than what I had dealt with in the past month.

I will see tomorrow an ophthalmologist for a follow up.

Thank you!

Syagrius