Herpes Simplex Keratitis

Question 1

What is a major cause of ocular morbidity

Answer 1

Herpes Simplex Keratitis
*HSV-1

Question 2

Where does the virus colonize/

Answer 2

1. In the trigeminal ganglion
   *leads to ocular infection due to reactivating of the herpes virus
2. Will be seen on lid, conjunctival or cornea

Question 3

What are some precipitating factors of herpes simplex keratitis

Answer 3

1. Excessive sunlight exposure
2. Fever
3. Stress
4. Menses

Question 4

What are the signs of herpes simples keratitis

Answer 4

1. History of fever blister
2. Vesicles on conjunctiva or peri-ocular area
3. Ulceration

Question 5

How is the diagnosis made of herpes simplex keratitis

Answer 5

1. Slit lamp and fluorescein stain
   *characteristic dendritic pattern
   *branching pattern similar to tree roots
2. Scrapings of lesions
   *Tzanck smear
   *presence of multinucleated giant cells

Question 6

What needs to happen if a patient presents with herpes simples keratitis

Answer 6

Emergent referral for ophthalmology
*NO topical corticosteroids
*increases chance of corneal melting
*increases viral replication.

Question 7

Who should make the decision whether or not topical steroids should be used for HSK?

Answer 7

Ophthalmologic

Question 8

What can be used for HSK

Answer 8

1. Topical antiviral agents
2. Cycloplegics
3. Topical NSAIDS
4. Oral antivirals
5. Debridement (possible)