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What are the precautions to be taken to prevent recurrence of herpes virus in the cornea?
We do not completely understand the herpes simplex virus or what triggers recurrence. In general, trauma or stress may play a key role, but we don't understand the degree of each that is required. When herpes simplex recurs on the lips, these sores are often called "fever blisters" and with good reason. If you have a tendency to get oral or ocular herpes, a fever from a cold or flu-like syndrome is a common trigger. Even generalized illness without fever can be a trigger for reasons we do not understand. Such trauma as a sunburn or facial wind burn may be enough bodily stress to permit a recurrence. Physical injury especially around the face including dental work or infection or bodily surgery may be a trigger for some. A generalized suppression of the immune system may make some individuals more susceptible and this would include such mild suppression of the immune system as eczema, asthma, and contact dermatitis. Menstruation and emotional stress may be precipitating events as well although these factors are controversial triggers. In other words, we are not certain if they are triggers or not, but certainly, if they are triggers, all individuals would not be affected.
The best prevention is to eliminate trauma or stress from your life, but that would be impossible. However, if you know that you are going to have periocular surgery, for example, and you have a history of ocular herpes, especially with frequent recurrences, then you may wish to discuss prophylaxis (preventative measures) with your Eye M.D. or ophthalmologist. Under certain conditions, medications may be prescribed that help prevent recurrence. If you have frequent recurrences you should discuss prophylaxis with him/her anyway regardless of potential trauma as the frequency of recurrences may be decreased or prevented.
Answered by: Ivan Schwab, MD
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