Viral eye: Emerging insights into corneal and ocular surface viral infections.

Abstract

Viral infections of the ocular surface significantly contribute to morbidity and visual impairment globally. The herpes simplex virus (HSV), adenovirus, cytomegalovirus (CMV), and human papillomavirus (HPV) are predominant pathogens impacting the cornea and conjunctiva, resulting in recurrent illness, epidemic outbreaks, and virus-associated neoplasia. Progress in virology, immunology, and molecular diagnostics has enhanced comprehension of host-virus interactions and introduced novel therapeutic opportunities. A narrative literature review was performed utilizing PubMed, Scopus, and Web of Science, encompassing papers published from 2000 to 2025, with a specific focus on research from 2020 onwards. Eligible publications were peer-reviewed clinical and experimental investigations, together with reviews that focused on epidemiology, etiology, diagnostic methodologies, and therapeutic alternatives. Research indicates that HSV keratitis is the predominant infectious cause of corneal blindness in high-income nations, although adenovirus persists in instigating epidemics of keratoconjunctivitis in the absence of licensed antiviral treatments. CMV keratitis, previously confined to immunocompromised persons, is now acknowledged in immunocompetent patients as a causative agent of corneal endotheliitis. HPV is associated with ocular surface squamous neoplasia, especially in areas with elevated ultraviolet exposure and high human immunodeficiency virus prevalence. Innovative molecular diagnostics, innovative antiviral agents, immunomodulatory approaches, and immunization initiatives signify significant progress that could enhance preventative and therapeutic results.