The answer is: yes, it can, even though not so often. An open cold sore could lead to an infection of the eyes through a smear infection by wiping the hand across the face. However infection of the retina (inside at the back of the eye) is of a particularly dangerous kind. If the virus invades the eye and infects the retina this may be destroyed. This, of course can lead to blindness1). Fortunately this is a rare event.
In other infrequent cases it has been observed that the herpes virus can causea paralysis of the facial nerve (Bell’s palsy)2). This means that patients can no longer move the muscles of a part of their face which is a serious condition.
A herpes genitalis infection (HSV2 –different from the facial virus) can be transmitted to the child during the process of the birth. The consequences for the newborn child can be severe as the virus can be spread throughout the body of the child through the bloodstream. In such a situation the newborn child can display widespread symptoms on his skin, in the cavity of the mouth and in the throat, in other major organs and in particularly severe cases even paralysis may occur3).
These severe diseases are luckily very rare. Even though 85% of the population are infected by one form of this virus (HSV1) most of the people don’t know. They don’t suffer from cold sores and they don’t have other symptoms living normally without affliction. However 33% of the population suffer regularly from cold sores. This is painful and often very unsightly for those affected.
In order to successfully target the infection it is important to take measures to prevent cold sores at an early stage.
1) M. Cordero-Coma et al.: Herpetic retinitis. (Review) In: Herpes Band 14, Nr. 1, 2007, S. 4–10.
2) S. Murakami et al.: Bell’s palsy and herpes simplex virus: Identification of viral DNA in endoneurial fluid and muscle. In:Ann Intern Med Band 124, Nr. 1, 1996, S. 27–30.
3) R. Marre, T. Mertens, M. Trautmann, E. Vanek: Klinische Infektiologie. München Jena 2000 ISBN 3-437-21740-2 S. 802f
E. Anzivino et al.:Herpes simplex virus infection in pregnancy and in neonate: status of art of epidemiology, diagnosis, therapy and prevention. Virol J. (2009) 6:40 (Review)