5 year old w/ Herpes Type 1 (HSV-1) and Ocular Keratitis
My son is 5 years old and has HSV-1. His first outbreak was when he was about 9 months old. Since then, he has had about 3 outbreaks each year. It has always been around his eye and on his cheek. He gets these places every time he is sick with a cold or some other type of infection. We didnít get the HSV-1 diagnosis until about a year ago when an after hours pediatrician saw him and did a culture. Despite the negative result (most likely because the place had already crusted over) she was still almost certain thatís what it was.
The places that he normally gets are always about the size of a dime or nickel. However, he recently had one come up that started out very small, but it was especially concerning because it was right on the corner of his eye, and around his eyelid. We took him to the after hours clinic and they started him on Zovirax ointment 5 times a day. He had never been on an anti-viral medications before, oral or topically. Our regular pediatrician had told us that there was no need to medicate him because the more outbreaks he had the more he would build up immunity to it. But this time around, since it was so close to his eye, they decided the topical treatment was needed. So we applied it for the first time that night when he went to bed.
When he woke up the next morning, we were shocked to find that the little spot had spread down his face, more on his eyelid, and on his cheek. We continued to apply the Zovirax ointment, but by that evening it was obvious it had spread into this eye. The whites of his eyes were bright red and he was experiencing light sensitivity. We went back to the clinic and this time saw a different doctor who consulted the Ophthalmologist on call. He advised us to start him on Viroptic 1% drops, 5 times a day and to follow-up with him in his office the next day.
When we went in to see the eye doctor that next day, my sonís eye looked better already. The drops seemed to be working and there was no damage to his cornea. However, he explained to us about the chance of reoccurrence. He gave us a copy of an article that talked about the use of Acyclovir prophylaxis in patients with Ocular HSV. We left with a prescription for Acyclovir 200mg/5ml oral suspension. He thought we would need to keep him on this for a year. He also told us that he had talked to our regular pediatrician and that she did not feel very comfortable with this, so she was going to want to follow-up with blood work.
We have since started on the oral dose, and we have followed up with bloodwork, as suggested. So far everything seems to be going okay. But my fear is that he will have to be on this medicine for the rest of his life. I worry about what will happen a year from now when we stop the treatmentÖ will he continue to have outbreaks and will they get worse and worse? That seems to be the trend so far.
I have no idea how my son got thisÖ but from what I have read it could have been from someone with a cold sore kissing him on the cheek when he was a baby. It has always been so sad to see him in so much pain when he has outbreaks. However, it has never seemed to bother him that much, until this most recent outbreak. He was miserable and he also became self conscious of his appearance. He was out of school for a week. But, when he went back it was still healing and he was embarrassed. He also still seems to have some light sensitivity in that eye, which concerns me.
We want to learn all we can about this so that we can help him. If anyone has anything they can share with us it would be appreciated so much.
Thanks in advance!