Overview
Eye herpes—also called ocular herpes or herpes simplex keratitis—is an eye infection caused by herpes viruses. The most common cause is herpes simplex virus type 1 (HSV-1), though HSV-2 and, less commonly, varicella zoster virus (the virus responsible for shingles) can also affect the eyes.
This condition can involve the eyelids, the surface of the eye (cornea), or deeper eye structures. It often requires prompt medical evaluation because untreated or recurrent infections can lead to scarring and permanent vision loss.
Close-up of a lesion (cold sore) at the corner of the eye in a 20 year old male patient infected with the Herpes simplex virus. Herpes simplex is a common viral infection that leads to painful skin blisters.
What Causes Eye Herpes
- HSV-1 is responsible for most cases of eye herpes.
- HSV-2 can affect the eye but is less common; it is more often associated with newborn infections through vertical transmission.
- Varicella zoster virus can involve the eye during shingles, a condition known as herpes zoster ophthalmicus.
After the initial infection, herpes viruses can remain dormant in nerve tissue and later reactivate, leading to recurrent eye infections.
How Eye Herpes Spreads or Reactivates
- The virus spreads through direct contact with infected saliva, sores, or bodily fluids.
- Autoinoculation can occur when a person touches an active cold sore and then touches their eye.
- Reactivation may occur after the virus has been dormant and has been associated with:
- Stress or fever
- Illness
- Ultraviolet light exposure
- Eye injury or eye surgery
- Immune suppression
Transmission of HSV from an infected eye to another person is considered uncommon, but careful hygiene is still important.
Symptoms of Eye Herpes
Symptoms can range from mild to severe and may affect one or both eyes. Eye herpes is sometimes mistaken for conjunctivitis (“pink eye”).
Common Symptoms
- Eye redness
- Eye pain or discomfort
- Watery discharge
- Sensitivity to light
- Blurred vision
- Foreign-body sensation (feeling like something is in the eye)
- Blisters or sores on the eyelid or skin around the eye
More Severe Symptoms
- Worsening vision changes
- Swelling of the cornea or eyelids
- Increased light sensitivity
- Signs of deeper eye involvement
One Eye or Both Eyes?
Eye herpes often affects one eye, but it can involve both eyes.
Types of Eye Herpes
Epithelial Keratitis
- Affects the surface layer of the cornea
- Often heals with treatment
- Usually does not cause permanent scarring when treated promptly
Stromal Keratitis
- Involves deeper layers of the cornea
- Can lead to inflammation, scarring, and permanent vision loss if untreated
Uveitis / Iridocyclitis
- Affects internal eye structures such as the iris or ciliary body
- Associated with more severe inflammation and vision symptoms
Possible Complications
Without appropriate treatment, eye herpes can lead to:
- Corneal scarring
- Recurrent inflammation
- Secondary glaucoma
- Permanent vision loss or blindness
Prompt diagnosis and treatment are associated with a lower risk of these complications.
How Eye Herpes Is Diagnosed
Diagnosis is typically made by an eye care professional and may include:
- Clinical eye examination
- Slit-lamp examination to evaluate the cornea and internal eye structures
- Corneal staining patterns
- Eye swabs for viral testing (such as PCR), when needed
- Measurement of eye pressure
- In some cases, blood tests indicating prior exposure
Treatment Options
There is no cure for herpes viruses, but treatment can control infection and reduce recurrence.
Common treatment approaches include:
- Antiviral eye drops or ointments
- Oral antiviral medications
- Anti-inflammatory medications, used cautiously and under medical supervision
- Topical antibiotics to prevent secondary bacterial infection, when indicated
In severe cases with significant scarring or structural damage, surgery may be necessary. Some individuals with recurrent disease may require long-term antiviral therapy.
Prevention
Eye herpes cannot be prevented with complete certainty, but risk can be reduced by:
- Avoiding touching the eyes, especially during an active cold sore
- Washing hands frequently
- Not sharing personal items such as towels, makeup, or eye products
- Managing stress and overall health
- Using UV-protective eyewear outdoors
- Following medical guidance for recurrent herpes infections
Vaccination against shingles has been shown to reduce the risk of shingles-related eye complications.
When to See a Doctor
Seek urgent medical evaluation if you experience:
- Sudden vision changes
- Severe eye pain
- Blisters or sores around the eye
- Rapidly worsening redness or swelling
- Intense light sensitivity
- New eye symptoms with a history of herpes infection
Early treatment is important to help preserve vision.
Frequently Asked Questions
Is eye herpes contagious?
The herpes viruses that cause eye herpes are contagious, but transmission from an infected eye to another person is uncommon. Good hygiene reduces risk.
Can eye herpes cause blindness?
Yes. Severe or untreated eye herpes—particularly infections affecting deeper eye layers—can lead to permanent vision loss or blindness.
Can eye herpes come back?
Yes. Herpes viruses can reactivate multiple times throughout life, especially during illness, stress, or immune suppression.
Is there a cure for ocular herpes?
There is no cure for herpes viruses. Antiviral treatment can control outbreaks and reduce recurrence.
What does eye herpes look like?
Eye herpes may cause redness, watery eyes, light sensitivity, and sometimes blisters on the eyelid or skin around the eye.
How long does eye herpes last?
With treatment, mild cases may improve within one to two weeks. More severe cases may take longer to heal.
Is eye herpes the same as pink eye?
No. Eye herpes and conjunctivitis can appear similar, but eye herpes often involves pain, light sensitivity, and blisters. A clinical exam is needed for diagnosis.
Can eye herpes spread from a cold sore?
Yes. Touching an active cold sore and then touching the eye can transfer the virus.
Does eye herpes always cause pain?
There is no high-quality evidence showing that eye herpes always causes pain; symptom severity varies by individual and type of infection.
APA Reference List
Ahmad, B., Gurnani, B., & Patel, B. C. (2024, March 10). Herpes simplex keratitis. In StatPearls [Internet]. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK545278/
Centers for Disease Control and Prevention. (2025, May 27). What causes HSV (herpes simplex virus) keratitis. https://www.cdc.gov/contact-lenses/causes/what-causes-hsv-herpes-simplex-virus-keratitis.html
Cleveland Clinic. (n.d.). Ocular herpes (eye herpes): Symptoms & treatment. Retrieved December 12, 2025, from https://my.clevelandclinic.org/health/diseases/ocular-eye-herpes
Merck Manual Professional Edition. (2024, July). Herpes simplex keratitis. https://www.msdmanuals.com/professional/eye-disorders/corneal-disorders/herpes-simplex-keratitis
Merck Manual Consumer Version. (2024, July). Herpes simplex keratitis. https://www.msdmanuals.com/home/eye-disorders/corneal-disorders/herpes-simplex-keratitis
Medical News Today. (2023, October 30). Eye herpes: Pictures, symptoms, and types. https://www.medicalnewstoday.com/articles/321693
National Health Service. (n.d.). Herpes simplex eye infections. Retrieved December 12, 2025, from https://www.nhs.uk/conditions/herpes-simplex-eye-infections/
Nijm, L. M. (2025, May 9). Herpes simplex epithelial keratitis. EyeWiki. https://eyewiki.org/Herpes_Simplex_Epithelial_Keratitis
World Health Organization. (2025, May 30). Herpes simplex virus. https://www.who.int/news-room/fact-sheets/detail/herpes-simplex-virus