Herpes Simplex Keratitis

Herpes viruses establish lifelong infections, and the virus cannot yet be eradicated from the body. Treatment usually involves general-purpose antiviral drugs that interfere with viral replication, reduce the physical severity of outbreak-associated lesions, and lower the chance of transmission to others. Studies of vulnerable patient populations have indicated that daily use of antivirals such as acyclovir and valacyclovir can reduce reactivation rates.

The virus can be reactivated by illnesses such as colds and influenza, eczema, emotional and physical stress, gastric upset, fatigue or injury, by menstruation and possibly exposure to bright sunlight.

Herpes Simplex Keratitis

is not common but needs to be treated to avoid corneal scaring; the corneal ulcer has typically a dendritic appearance.

The HSV-1 virus normally appears in the eye as a dendritic ulcer, corneal sensation is reduced, this may progress to a geographical ulcer

Treatment

Aciclovir 3% ointment 5 times daily (Zovirax)

Ganciclovir 0.15% gel 5 times daily (Virgan)

Cycloplegic may be needed  if anterior chamber reaction is present

Disciform Keratitis a gradual painless onset of blurred vision and may require treatment with topical steriods, topical anti biotics and anti virals, Oral antivirals may all so be prescribed.

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