Oral and Maxillofacial Surgery Expert Forum
ocular herpes after bone grafts
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Questions in the Oral and Maxillofacial Surgery forum are answered by Dr. Michael H Kirsch and Dr. Mario Tuchman. Topics covered include teeth extractions, wisdom teeth, dental implants, bone grafting, orthognathic surgery, facial bones realignment, facial trauma repair, jaw alignment, anesthesia , jaw cyst or tumor diagnosis, reconstructive jaw surgery, temporomandibular joint syndrome (TMJ) and TMJ surgery.

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ocular herpes after bone grafts

I had bone grafting, then several days later my right eye became very red, i was placed on cleocin 150mg tid, after about a week and a half, my eye seemed to be getting better. I had another bone graft done, then my eye flared up again, was put on gentamaycin eye drops and back on cleocin at 600mg. Eye getting worse {very very red, painful}. went to an opthamologist where he diagnosed ocular herpes to the epethial layer, not the cornea. i was placed on antiviral eye drops and a broad spectrum eye antibiotic in adition to oral antivirals. he stated in his experience, major dental/periodontal work can trigger the trigeminal nerve and since I had a fever blister years ago, I had the virus in me...so this time it went to my eye. I need additional bone grafts done.
#1: how long should I wait until I get the grafts...I want this current episode of ocular herpes to "settle down". I feel a "fullness" in my ear and around my right eye, not pain but not just not the same as my left side. My eye is better.
#2: What are the chances of getting it again after the graft?
#3: If I do get it again will it be a worse case? The episode lasted a good 7 weeks.  
#4: should I always be taking the oral antiviral...valtrex?
thanks you,
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#1 Have you consulted with your surgeon? I would first ask their opinion, as I'm not sure why you are having so many individual bone grafting procedures.
#2 as of now, you're 2/2. I'd say your chances of "getting it again" is ~100%
#3 and #4 There are risks to recurrent and prolonged Ocular Herpes infections. Patients can develop permanent corneal scarring and may need corneal transplantation to restore their vision. In addition to discussing your concerns with your surgeon I would discuss them with your ophthalmologist.
Hope this helps guide you in the right direction.
Dr T

Information contained within this reply is intended solely for general educational purposes and is not intended nor implied to be a medical diagnosis or treatment recommendation.  This is not a substitute for professional medical advice relative to your specific medical condition or question.  Always seek the advice of your own doctor for medical condition.  Only your doctor can provide specific diagnoses and therapies.
I had 5 dental inplants several years ago, they are not causing me any problems, however, my dentist noticed some bone loss and recommended bone grafts to avoid future problems.
I went to my opthamologist today and he said the same thing you did...100% chance of getting it again and most likely with corneal damge if I dont use antiviral eyedrops within 6 hours of symptoms. I need to always have trifluridine with me. My pressure in my eye was elevated, it was 19...today it was 16, I go back in 6 weeks to have it checked again. He said glacoma could also be a complication.
Thank you for your response.
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Dr. Michael H. Kirsch
Caldwell, NJ
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