She Had Acanthamoeba In Her Eye. Why Did They Call It Herpes?

Posting Date: 06/29/2000

Peter: Three years ago my mother was in the Caribbean and she got an acanthamoeba infection in her eye. The organism was in the water that she washed her contact lens with.

She was misdiagnosed with herpes simplex of the eye and given the wrong medication for six months. She lost her vision in that eye and is now scheduled for a cornea transplant.

Is there even such a thing as a herpes eye infection? If so, how do you catch it? Does genital herpes spread to the eye?

Dr. Dean: First let me warn everyone that contact lenses should never be washed in tap water, or in anything other than a sterile saline solution. Acanthamoeba is not just a Third World thing. It lives in water in this country too.

Follow the manufacturers' instructions on contact lenses, and do not wear the extended wear type beyond their end date.

The good news is that corneal transplantation has a high success rate, so your mother is likely to recover well.

Yes, herpes in the eye is real. It is called herpes keratitis and I'm afraid it's fairly common. It has a distinct look -- what is called a dendritic or branching ulcer -- so I'm disturbed by the misdiagnosis. Also, a herpes diagnosis can be confirmed by a culture.

We don't know exactly how herpes infects the eyes, but it hides out in the nervous tissue of most human beings. Possibly the virus travels through the nervous system to the eye and an eruption is triggered by an irritant the same way that oral and genital herpes outbreaks occur.

Most people with cold sores know the specific triggers that spur outbreaks. And a study found that men with genital herpes that had been dormant for years got an attack when their genitals were exposed to a sunlamp.

Perhaps an outbreak of herpes keratitis is triggered by the irritation of a contact lens against the cornea. It can be very difficult to treat, and because of that challenge, ophthalmologists were the first physicians to use the anti-herpes drugs that are now commonly used to treat genital herpes.

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