HSV & Iritis

LokiBot · Post by **LokiBot** » Thu May 24, 2007 4:11 am

Good Morning,

I was wondering if anyone could help about 3 months ago my girlfriend contracted genital HSV-1 from a cold sore on my lip. About two weeks after her initial outbreak she had a second outbreak during this time both her eyes began to get bloodshot. I took her to a doctor fearing it could be ocular HSV-1 after some persuation he done a slit test said her eyes had no bendrics and because it was in both eyes he didnt suspect HSV done a swab and told her she had mild iritis. He gave her some steroid drops which worked within a week. We went back a week later he redone the slit test said her eyes where better but that the swab test results werent back to try and find the cause. He would send the results onto her normal doctor and they would contact her if there was anything to worry about.

Now the doctor never called her and she has forgot all about the results however my worry lives on! In someone who has been through this's opinion is it herpes related? I read that Iritis is normaly only present after an initial infection in her eye of HSV-1 IE it's the later stages of the virus. She has never had any issues with her eyes herpes related or otherwise so it's doubtful.

Does anyone have any insight?

Mike Bartolatz · Post by **Mike Bartolatz** » Thu May 24, 2007 9:02 am

you might ask this question of DR Foster at his site at http://www.uveitis.org
iriits related to the herpes sx virus can cause a holes to occur in the iris as can syphilis.
HSV related uveitis is under diagnosed from what I have read so I don't know if anyone can comment without examination by an expert in causes of uveitis. HSV uveitis can be very difficult to control and is often a lifelong battle requiring oral antiviral medications as well as corticosteroids. if her uveitis returns you might want to get input from an Ocular Immunologist as the consequences of HSV related uveitis can be very severe if not controlled should the virus get into the posterior chamber. it can lead to acute retinal necrosis very quickly.

Wish her the best for me please,
Mike

LokiBot · Post by **LokiBot** » Thu May 24, 2007 10:15 am

Thanks Mike I spoke with Dr Foster he said it could be related and if it was to take 800g of ancholiver each day to supress it. Still no further forward in finding out if it is related though does anyone happen to know how it would be diagnosed? The done the swab and I assume that came back negitive or they would have called her right?

Mike Bartolatz wrote:you might ask this question of DR Foster at his site at http://www.uveitis.org
iriits related to the herpes sx virus can cause a holes to occur in the iris as can syphilis.
HSV related uveitis is under diagnosed from what I have read so I don't know if anyone can comment without examination by an expert in causes of uveitis. HSV uveitis can be very difficult to control and is often a lifelong battle requiring oral antiviral medications as well as corticosteroids. if her uveitis returns you might want to get input from an Ocular Immunologist as the consequences of HSV related uveitis can be very severe if not controlled should the virus get into the posterior chamber. it can lead to acute retinal necrosis very quickly.

Wish her the best for me please,
Mike

Mike Bartolatz · Post by **Mike Bartolatz** » Thu May 24, 2007 3:48 pm

the 'swab' only tests the surface of the eye, not the area where iritis is located. the fluid in the aqueous chamber would have to be biopsied in order to tell for certain and either ELISA or PCR testing for genetic material for HSV would then indicate if it is or isn't HSV If it is suspect without the usual 'signs' seen from HSV iritis.
this is why I indicated the need to see a specialist who knows what tests to do, has an experienced Lab to do the tests as well. some samples have to be taken on certain days of the week for example in order for them to arrive at the lab and get the tests done. how the sample is handled can mean a negative response too. EXPERIENCE is EVERYTHing with the diagnosis and treatment of all Ocular Inflammatory disease processes as well as lookiing for related autoimmune disease processes.

wish her the best,
Mike

LokiBot · Post by **LokiBot** » Fri May 25, 2007 7:23 am

Ahh ok thank you very much Mike!

One last question her eyes have been "quiet" since the original incedent can the tests still be done now? It cleared up after 4 days worth of steroid drops 5 times a day and hasnt been seen since (2- 3 months now) from what I have read on this site Iritis is "normally" far more foreboading than that.

I spoke with a specialist yesterday in the UK who said the way in which it presented with no increased presure no Keratitis no other ocular envolvement and the fact it was in both eyes at the same time he would have said it had nothing to do with HSV too or wouldnt have ever have thought about it due to all these facts.

Whats your opinion on that?

Mike Bartolatz · Post by **Mike Bartolatz** » Fri May 25, 2007 10:20 am

I have no opinion on this. if it returns, then perhaps additional testing for the HLA B27 marker in her blood could be done. time will tell. i hope it never returns for her. i'm not a doctor and no one can tell over the internet what is causing her problem. we can only provide information that people can consider indicating the most common causes of uveitis. there are more than 85 things that can cause or trigger a bout of uveitis. some are autoimmune, some are pathogens etc. often no cause is ever determined and it is called ideopathic. just be vigiliant for possible systemic involvement to autoimmune disease processes. should joint pain begin, rashes appear on her skin, vascular or GI complaints or neurolgical issues arise , breating or hearing problmes etc. then bring them to the attention of doctors.

Take care,
Mike