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Updated: Jun 21 2015

Herpes Simplex Keratoconjunctivitis

Snap Shot
  • HSV keratitisA 25-year-old woman has moderate tearing pain in her left eye. She was recently placed on topical corticosteroids for suspected allergic conjunctivitis. A gram stain and Giemsa stain are negative for organisms. A fluoroscein stain of the eye exhibits a shallow ulcer with a dendritic appearance and irregular borders. 
Introduction
  • Infection of the conjunctiva by HSV typically following vesicular eyelid eruption
    • herpes labialis may or may not be present
  • Corneal involvement is often precipitated by topical or systemic corticosteroid treatment
Evaluation
  • Fluoroscein stain examination
    • exhibits a shallow ulcer with a dendritic appearance and irregular borders
Treatment
  • Topical antivirals
    • idoxuridine
    • vidarabine
    • trifluridine
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