Acyclovir is used to treat shingles as well as herpes simplex virus and other types of herpesvirus infections which can cause painful blisters and lesions. Acyclovir reduces the severity of outbreaks and prevents the development of new blisters. Acyclovir cannot treat CMV disease, which is also caused by a herpesvirus. Acyclovir can prevent herpes simplex outbreaks, which may help people co-infected with HIV and herpes simplex live longer. High dose acyclovir is used to treat hairy leukoplakia , a viral infection that usually shows up on the sides of the tongue.

Eye Herpes

Eye Herpes is usually treated with trifluridine

Herpes Keratitis, commonly known as Eye Herpes is an inflammation of the cornea, the clear dome that covers the front part of the eye. Herpes Keratitis is caused by the Herpes Simplex viruses.

Normally Herpes Simplex causes cold sores or Genital Herpes but sometimes the virus may attack the eye as well, causing Keratitis (Keratitis may also be caused by other viruses and illnesses). Usually Keratitis is seen some time after a Herpes illness and tends to take form of a reactivation of the illness, usually only in one eye. The symptoms of Herpes Keratitis are:

• Blurred vision
• Sensitivity to light
• Pain and redness of the eye
• Tearing
• Decreased vision

Eye Herpes is Mostly Harmless - You Should Still See a Doctor Though

Herpes Keratitis is often harmless and can go away on its own, but sometimes treatment is needed. You should see your doctor for diagnosis, advice and treatment. Herpes Keratitis is diagnosed via a slit lamp examination. Tinted eye drops that highlight affected areas in the eye may also be used to assess the extent of the Keratitis infection.

Antiviral drops or ointment may be needed to clear the virus
If the infection is severe, antiviral eyedrops or ointment will be prescribed, Trifluridine or Vidarabine. Sometimes, to assist the healing process, the doctor may gently swab the cornea with a soft cotton-tipped applicator to remove infected and damaged cells. In serious cases Keratitis may cause

• Chronic inflammation of the cornea
• Scarring of the cornea
• Development of tiny blood vessels in the eye
• Glaucoma
• Loss of vision
• Blindness

If the Keratitis infection is severe, steroids in the form of eye drops may be prescribed to decrease inflammation and scarring. If the cornea is scarred so much that there is loss of vision, a corneal transplant may be required. There is rarely more than one occurrence of Keratitis caused by Herpes in a lifetime if you are in good health.

So Who is at Risk from Eye Herpes?
There is no particular pattern to who gets Herpes Keratitis and who doesn't. Obviously a Herpes virus has to be present in the body already, but most people carry some kind of Herpes virus if not more than one, often without being aware of it. The same care to prevent normal outbreaks of Herpes Simplex should be followed:

• Get enough sleep
• Eat a well balanced diet
• Keep yourself fit.
• Aim to avoid stressful situations
• Do not touch your eye if you have a cold sore
• Be very hygienic if you wear contact lenses
• Additionally, be careful to wear sun glasses when exposed to very
• bright light, ie when skiing or out on a bright day

Acyclovir is now a generic drug

Side effects
Acyclovir has a good toxicity profile, meaning that long term use does not produce major side effects. Stomach upset, headache or nausea are possible. Hair loss from prolonged use has been reported.

Dosage
Acyclovir is available in ointment, pill, liquid, and intravenous (injection) forms. Ointment is applied every 3 hours, 6 times per day for 7 days. Pills come in doses of 800 mg and 200 mg. Severe acute episodes that do not respond to oral medications can be treated with IV acyclovir. Resistant strains can be treated with foscarnet (Foscavir). For shingles, the 800 mg tablet is used unless IV treatment is needed. You cannot take ddC with acyclovir until you are stable on acyclovir. Dosage reduction is required if you have kidney failure. If you are pregnant or breast feeding, it is recommended that you do not take acyclovir.

How long it may take to work
Herpes sores usually disappear in a few days after starting treatment. Effectiveness is noted by crusting over and healing of sores. Long-term therapy with acyclovir may be required if you have chronic outbreaks of herpes.

Managing side effects
Medications to help reduce symptoms of nausea include Compazine, Phenergan, and Reglan. Nutrition strategies such as eating dry salted crackers and not lying down after you eat can help reduce stomach upset. Aspirin or pain killers may help with headache. Dosage may be adjusted if side effects are severe.