Herpes simplex lid skin infection
By Dr. Rasha Al-Dulaimy
34 yrs old female, medically free, presented with multiple small painful rashes on her left upper eye lid, no history of trauma…causes and management ??
By Dr.Hussein Berjawi Herpes simplex lid skin infection, treat topically with acyclovir ointment 5 times daily, systematic acyclovir is not needed in such a case (unless the patient is immunocompromised), you should check out the ocular surface to rule out dendretic corneal ulcers (if ocular surface is involved then the ointment should be used for ocular surface too), the patient should be prevented from itching the lesions & also routine follow up till the lesions disappear to rule out secondary bacterial infection
By Dr.Mohamed Sandeed Herpetic blepharitis. I would perform a thorough eye exam to rule out corneal involvement.
Herpes simplex eye infection is caused by a type of herpes simplex virus. An episode often clears without any permanent problem. However, in some cases the infection causes scarring to the transparent front part of the eye (the cornea). This can lead to permanent loss of vision. Prompt treatment with antiviral eye ointment or drops helps to prevent corneal scarring.
Most episodes of active infection are due to a reactivation of the virus at some point, often years after a primary infection. Symptoms include:
- Redness of the eye – mainly around the transparent front part of the eye (the cornea).
- Ache or pain in the eye.
- Discomfort when opening the eyes in bright light (photophobia).
- Watering of the eye.
- Blurring of vision.
You may also notice a blistery skin rash around the eyelids (but not in all cases). It is usually one eye that is affected.
The main concern with corneal infection (keratitis) is that it can cause scarring of the transparent front part of the eye (the cornea). With scarring, the normally clear cornea can become like frosted glass. This may sometimes seriously affect vision.
- Epithelial keratitis tends to settle and go away within a few weeks. It has a good outlook and often causes little or no scarring.
- Stromal keratitis is more likely to result in corneal scarring and loss of vision.
- Recurring episodes of active infection can make any existing scarring worse.
- Prompt treatment with antiviral eye ointment or drops helps to minimise damage during each episode of active infection.