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Had herpes infection in cornea. Is corneal transplant safe? Chances of appearing herpes in other eye?

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Practicing since : 2000
Answered : 101 Questions
Hello. About 20 years ago my wife was "hit" with a herpes infection in her cornea. Thank heavens it was caught in time, however, the cornea was slightly damaged and the doctor said it would never get back to normal even with glasses, and that the other eye would compensate in her vision. He and other doctors did not encourage the idea of corneal transplant. My question is: Is a corneal transplant particularly problematic and don't they usually succeed well to be able to give proper vision. Her other eye apparently does compensate but we were wondering about the idea of the transplant. And what are the chances that the herpes in her system could reappear in either eye (which so far in 20 years has not happened)?
She also did the trabeculoplasty laser a few years ago for both eyes although her eye pressure was normal. Could there be a connection between the two problems? Thank you.
Posted Wed, 8 Aug 2012 in Vision and Eye Disorders
Answered by Dr. Mihir Shah 6 hours later

Thanks for the query.

Firstly let me explain to you that corneal transplant is not a simple surgery. The first hurdle is to procure a healthy cornea. Even if you can procure a cornea, there are chances of rejection of corneal graft. Secondly, the surgical procedure involves suturing the graft onto the eye with 16 sutures. This will invariably cause some amount of astigmatism which will lower the quality of vision. It is possible that the patient will end up with a vision which is lower than the previous vision.

There is no chance of recurrence of herpes in the other eye. However herpes can recur in the same eye but in your case the chances are very low.

Trabeculoplasty laser has no relation with herpes infection. However there are certain eye drops (prostaglandins) which are normally used to reduce eye pressure, which can cause recurrence of herpes infection. So prostaglandins should be avoided.

Hope I have answered your queries. I will be available to answer any further queries, if you have any.

Best Regards,
Dr.Mihir Shah
Above answer was peer-reviewed by
Follow-up: Had herpes infection in cornea. Is corneal transplant safe? Chances of appearing herpes in other eye? 2 hours later
Thank you, Dr. Shah. I am not sure I understand why a person would need a trabeculoplasty procedure if pressure is normal, especially for both eyes. And especially since there was no history of glaucoma in my wife's family.

On another matter, how common is it for someon to have different vision in two eyes? My correction in my left eye is different that my right. In my left eye I can see up close but not in the distance, and in my right eye I cannot see up close (myopia) but can see in the distance.
Also, what is the usual statistical rate of success in corneal transplants in general, especially in the US? Is rejection fairly common in the near or long run? And what is the initial cause of herpes in the eye, and why would it erupt only in one eye and then never recur again in either eye?
Answered by Dr. Mihir Shah 52 minutes later

Thanks for writing back.

It is possible for a glaucoma patient to have normal or low eye pressure. It is known as normal or low tension glaucoma.

It is quite common for a person to have hypermetropia in one eye and myopia in the other.

The success rate of corneal transplant surgery varies with various factors like the patient's age, donor corneal quality, surgical skills of corneal surgeon etc. Approximately 20 percent of corneal transplant patients reject their donor corneas
Usually the initial cause of herpes is a epidemic conjunctivitis which later involves the cornea. The herpes virus DNA remains trapped in the corneal cells and may persist there for life. If it is undisturbed it will never recur. However if the cornea is disturbed either by trauma or surgery, this DNA will become active and cause reactivation of disease. There is no route for transmission of this DNA to the other eye. So the other eye is safe.

Hope I have answered your queries.

Best regards,
Dr.Mihir Shah
Above answer was peer-reviewed by
Follow-up: Had herpes infection in cornea. Is corneal transplant safe? Chances of appearing herpes in other eye? 28 minutes later
Is it possible to have epidemic conjunctivitis and the herpes doesn't appear for many years?
I personally have eye pressure of 21 and 22 and my doctor says some people have higher numbers but do not develop glaucoma. I also have a nevus near the macula that was only discovered a few years ago. The doctor thinks I may have had it my whole life. Are there any risks associated with a nevus? Could it change into something worse?
Answered by Dr. Mihir Shah 3 hours later

Yes it is possible for herpes virus to remain dormant for many years.

Eye pressure of 22 is a bit on the higher side.You are said to have glaucoma only if you develop field defect or optic disc changes.Get your eyes checked once in a year.

A nevus at the macula is usually congenital in nature.A nevus is a benign lesion and does not cause any problems.Since it has remained the same your entire life, it is not likely to become malignant.

I hope I have answered your queries.

Best regards,
Dr.Mihir Shah
Above answer was peer-reviewed by
Follow-up: Had herpes infection in cornea. Is corneal transplant safe? Chances of appearing herpes in other eye? 28 minutes later
Thank you. My wife tells me she does not remember ever having conjunctivitis (which could have caused the eye herpes). Could there be some other cause?

My nevus was only discovered a few years ago. I don't even know why any previous doctor never saw it before. I have had field vision tests 2 or 3 times in recent years and all is normal. I always thought eye pressure correlated with glaucoma, but evidently not since as you said, someone can have normal pressure and have glaucoma, and higher pressure and no glaucoma.
Do these two conditions correlate with any other physical conditions one way or the other?
Answered by Dr. Mihir Shah 12 hours later

Your wife might not remember having conjunctivitis because sometimes it occurs only as mild red eye.

As far as I know there are no other associations for nevus or glaucoma.

Hope I have answered your query.

Best regards,
Dr.Mihir Shah
Above answer was peer-reviewed by
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