Please tell me about ocular herpes.

May 15, 2010 1:58 PM

Please tell me about ocular herpes.

As far as I know, I do not myself have any form of herpes. I do have some questions about ocular herpes, however:

1) Does someone who has ocular herpes necessarily have oral or genital herpes? How common is it to have ocular herpes only? Does ocular herpes tend to spread to become oral and/or genital infections?

2) If there are some people who have ocular herpes only, how contagious and transmissible is this form of herpes? How likely would a sexual partner be to acquire herpes if dating a person with ocular herpes only?

posted by anonymous to health & fitness (9 answers total)

1) I have only heard of people getting ocular herpes by touching their eyes after touching their own mouths (already having oral herpes). I guess if someone with oral herpes touched someone else eye, they could have only ocular.

2) Will the person with ocular herpes touch their own eye and then yours? Will you put your eyeballs together? Depends what you're into.
posted by BusyBusyBusy at 2:15 PM on May 15, 2010

i was diagnosed with optical herpes quite a few years ago. it was suspected that i picked up the infection from mishandling my contact lenses, which was most likely the culprit. i did not have herpes at the time.

as for being transmissible--the doctor never gave me any warnings. i only had one outbreak--and it was pretty painful and uncomfortable.
posted by lester's sock puppet at 2:25 PM on May 15, 2010

I hadn't heard of ocular herpes until reading this. I heard in health class that your cold sores (type 1 herpes) can spread to your eyes but not there was a third type of herpes. But a cursory google search tells reminds me that one shouldn't think in terms of "oral" or "genital" herpes. It is type 1 and type 2. Type 1 is mostly found in the mouth and face, and type 2 is mostly in the genitals.

This article (http://www.geteyesmart.org/eyesmart/infections/herpes_keratitis.cfm) says that herpes keratitis is type one (or 'oral' herpes) that is in the eye.

So to answer your questions:
1) Yes. By definition ocular herpes is type one herpes. Since herpes is herpes, it appears to be spread from someone with an open (mouth) sore and they rub their eyes. Once infected, one might be able to spread it to other skin parts on the body including the genitals.

2) since it is type one herpes that has sores on/near the eye. Since practically everyone (90% of the population) get exposed to it as a child it is over. People with herpes sores need to avoid touching their eyes. To avoid getting occular herpes from someone you should avoid having a person with active sores on the mouth kiss your eyes. However, note that both type 1 and 2 herpes can be spread when sores are not present so you should be careful in any eye-oral or eye-genetial contact.

I knew girls in high school (back in the mid 80s but I remember it because it was so gross) that would sometimes pop their contact lenses out and re-lubricate them in their own mouth (these were hard contact lenses) and pop them back in. I told my eye doctor about that and she looked mortified and told me that not only could you get coldsores on your eye, but the mouth is full of other things that are just terrible for your eyes. I told the girls at school about that the next day.
posted by birdherder at 2:50 PM on May 15, 2010

Since practically everyone (90% of the population) get exposed to it as a child it is over.

This is not true worldwide. Please see the chart on the wikipedia page. For example, in the US, 58% have HSV-1 in their blood; 23% of females of HSV-2, and 11% of males have HSV-2. I think it's important to understand that not everyone has it -- if we think everyone does, then that leads to a level of complacency. Not everyone has it; the people who don't have it generally prefer not to get it.
posted by Houstonian at 4:39 PM on May 15, 2010 [3 favorites]

Oops - wiki link.
posted by Houstonian at 4:40 PM on May 15, 2010

The Digital Journal of Opthamology has a question-and-answer article about ocular herpes. It says, "The source of infection is usually a family member or friend who is silently shedding virus in the saliva or nasal secretions, or who has an active cold sore. When the virus first enters the body, usually through the nose or mouth, it travels through the nerves up to the same center, which also sends nerves to the eye. There it goes to sleep in an inactive infection state and may never reawaken. Occasionally, the virus does reactivate (stress!) and, instead of traveling back down the nerves to the mouth or nose, it goes to the eye causing the illness there. "
posted by Houstonian at 4:53 PM on May 15, 2010

The herpes virus in general is very common and people often are infected without showing any symptoms while at the same time shedding the virus. For this reason it is very hard to answer your questions about how many people only have ocular herpes and what the rates of transmission are. If you don't want to get herpes, the only safe thing to do is to never touch anyone.

If you don't want to live a Howard Hughes like existence, then practice safe sex and good basic hygiene and you should be fine. If you do get herpes, it is not the end of the world as it is a relatively easily treatable disease with mild symptoms.

Note that the chicken pox virus, Varicella zoster, is very closely related to the herpes simplex viruses. Varicella can lead to shingles, (Herpes zoster), which in its ocular form has very similar symptoms to ocular herpes and is treated with the same drugs.
posted by afu at 11:53 PM on May 15, 2010

If it helps, I've had oral herpes/coldsores for years and never once got an eye infection, and I wear make-up and otherwise touch my eye. Risk might be greater for contact-lens wearers, however.
posted by mippy at 10:18 AM on May 16, 2010

Make sure you're not confusing herpes zoster ophthalmicus with herpes zoster keratitis.
posted by gramcracker at 8:45 PM on May 16, 2010