How is herpes zoster ophthalmicus treated?
Because herpes is a virus, antibiotics such as penicillin are not an effective treatment. The only drugs that will work against herpes infections are antiviral medications.
Depending on how serious the herpes zoster ophthalmicus is and what part of the eye is affected, your doctor will recommend antiviral eye pills, drops or both. No matter what kind of medicine is recommended, it is important to keep using the medicine for as long as your doctor recommends. Even though the eye might start to look or feel better, the infection could come back if you stop taking your medicine too soon.
If the infection is affecting the cornea, another kind of eye drops called corticosteroids might also be recommended. Corticosteroids can help control the inflammation caused by the disease, but in some patients they can also raise the pressure in the eyes. If corticosteroids are being used, it is important for the patient to come back to the doctor's office so the pressure can be checked. In some cases, a drop that dilates the pupil may be prescribed to prevent damage to the iris (the colored part of the eye) caused by inflammation.
Unfortunately, herpetic eye disease can be painful even after several days of treatment when the eye is starting to look better. This can be discouraging, but it does not mean that the treatment is a failure. The medicines are working, and the pain will go away eventually. (For some people, post-herpetic neuralgia [chronic pain] may persist from nerve damage from the infection. In rare cases, long-term medications may be necessary to treat symptoms.)
How is herpes simplex keratitis treated?
The same types of eye drops and pills are prescribed to treat herpes simplex keratitis. It is also just as important to use the medicines as recommended, and to keep all appointments with your doctor.