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Avatar universal

Herpes in the eye?

Hello, this is my first time on this website.  I've had what seems like a chronic herpes infection in my eye that seems to become red and inflamed when I'm under stress.  I've received two conflicting recommendations about whether to take Acyclovir long term as a way to prevent a recurrence.  My old doctor (who is now in another state) recommended that I take 400mg for 5 times a day following a recurrence and stay on a maintenance dose of 400mg for 2-3 times, possibly for the rest of my life.

However the new doctor that I am with (who has admitted a lack of experience with Acyclovir) feels that this is a very high dose and warned me that the drug could cause kidney problems over the long term.  The second doctor recommends a dose of one 400mg dose a day, eventually tapering off to stopping the Acyclovir.

In addition, other doctors I have seen in the past have suggested that a dose of 800mg of Acyclovir 5 times a day is a better treatment.  One doctor mentioned this NIH herpetic eye disease study: http://www.nei.nih.gov/neitrials/static/study37.asp where patients were treated with 400mg, 5 times daily for 10 weeks.

I just had some inflammation in my eye two days ago, but have been unable to see a doctor due to the Thanksgiving holiday.  By Friday, it seems to be going away.  I am wondering what is the best course of action preventing any future outbreaks.  Thank you very much for any advice you can give on this matter!
3 Responses
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284078 tn?1282616698
MEDICAL PROFESSIONAL
Try one of the university eye centers.  I'm sure there a many professors who specialize in corneal diseases.

MJK MD
Helpful - 0
Avatar universal
Thank you for your advice.  Can you recommend any doctors in the New York City area who have experience with or specialize in treating herpes keratitis?  Thanks again.
Helpful - 0
284078 tn?1282616698
MEDICAL PROFESSIONAL
I'm not going to question the regimens given by your doctors.  I don't know the specifics of your situation.  If you have herpes keratitis you should be on antiviral drops and sometimes oral antivirals to supplent it.  If infection involves eyelid or facial skin only then oral antivirals and sometime antiviral drops are used for first 7-10 days and a prophylactic dose after that.  Acyclovir, Famvir and Valtrex are all available as oral antiviral drugs.  The dose can be modified according to your specific situation also taking into account your kidney function, immune status, weight, severity of infection and other factors.  The key is to take these medication under a doctor's supervision and direct your questions to your doctor.

MJK MD
Helpful - 0

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