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Treating CARUNCLE with STEROID drops. Will it cause HSV1?

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Dr. Manish Malhotra we have been discussing caruncle and hsv-1, and I went to see an ophthalmologist today and he looked in my eye with a few different things and numbed my eye and looked with something else and checked the pressure of it, and ended up giving me a perscription for eye drops called neomycin/polymyxin/dexamethasone - ophthalmic drops. I was wondering if you knew about those and if they were ok for me to use? I asked about hsv-1 spreading to my eye and his words were sometimes it can spread there and activate there and it's basically a luck of the draw type thing and it can happen to anyone with hsv at anytime. So he didn't reassure me very well on that subject. He did say the risk is higher with older age but it could happen to anyone anytime it's just bad luck. Also my concern with those drops he prescribed me was that he called them a steroid drop and I have read online numerous times that steroid eye drops can in fact cause hsv in the eye? Is that true what I have read numerous times? I'm afraid to use them to tell you the truth after some things I have read, I heard they can weaken the eyes immunity and cause an hsv outbreak. I don't know what to do doctor?

Category: Ophthalmologist

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Category: Ophthalmologist
 20 Doctors Online

Thank you fo your query at
Regarding HSV-1, or herpes in general, it all depends on individual to individual. Studies say 30 % of US population by the age of 30 has herpes-1. Among them only a few will have a full blown disease. So regarding it spreading to the eye, there are chances but it is very low. I still state the one exposure you had won't cause any transmission of infection.
Now the drops he gave is apt. Since he could physically examine you, he understoos the need of antibiotics. Steroids can weaken the immunity, yes, but not if the drop is used for 3-4 days. Reading things from google can be scary, so try to avoid it as much as possible. The steroid component is important to reduce the inflammation. You can go ahead and use the drops without any hesitation.

Patient replied :

He actually wants me to use the drops for 7 days. As you can see in the pictures below that's what I have and the warnings and things that came with it. I'm scared to use it honestly. Im scared that while I may not currently have an hsv-1 infection that using these drops 3-4 times a day over the next 7 days will cause an infection to activate there by traveling through my nerves.

Rather than using it for 7 days, i suggest you use it for 3 days.
The inflammation will come down.
I can assure you, in 3-4 days time, steroid won't cause any harm. Only long term steroid use can weaken your immunity.
You have to trust your doctor here.

Patient replied :

I'm trying to trust him it's just hard to. Especially with all those warnings on the material with the drops saying if you have the herpes simplex virus don't use these drops.

Rather they are trying to imply if you have previous history of herpes infection in the eye, or suffered from HSV keratitis then do not use the drop.
Anyway you can always just pick up Ciplox eye drops or Neosporin eye drops.
It will also help reducing the infection.

Patient replied :

So that warning that I underlined on that paper that came with the drops that sent a picture of to you is only referring to those who have had an outbreak in there eye before? It's not meaning that everyone who has hsv-1 should avoid the drops?

Yes those with previous history of HSV keratitis, or those with a present active HSV lesion are predisposed.
However i advise you get Ciplox/ Neosporin exclusively without the steroid component.
Because you seem to be suffering froma lot of anxiety, which is understandable, and using the steroid drop will only cause further anxiety.
You can ask your local physician to give you a prescription for Ciplox eye drops or Neosporin+ Polymyxin eye drops without steroid component.

Dr. Manish Malhotra
Category: Ophthalmologist
Fellowship: L. V. Prasad Eye Institute, Hyderabad
Fellow Pediatric Ophthalmology & Squint (L.V. Prasad Eye Institute, Hyderabad)
Medical School, Residency: MBBS, DOMS, FLVPEI, Nagpur university, 1995
Dr. Manish Malhotra and 4 other Medical Specialists are ready to help you

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