Herpes Simplex Keratitis

Question 1

What are the typical symptoms of HSK?

Answer 1

Red eye
Pain
Photophobia
Tearing
Decreased VA
Vesicular rash
Previous episodes
Fever blisters
*Usually unilateral

Question 2

What are the common signs of HSK?

Answer 2

Vesicles
Acute unilateral follicular conjunctivitis
Dendrites OR geographic ulcer with dendritic edge
End bulbs stain with rose or lissamine
Decreased K sensitivity

Question 3

What is the Tx for skin involvement?

Answer 3

Topical acyclovir ung 5x/day
OR
Ganciclovir 0.15% gel 5x/day

Question 4

What is the Tx for herpes simplex conjunctivitis?

Answer 4

Ganciclovir 0.15% gel 5x/day
OR
Trifluridine 1% 5x/day
OR
Vidarabine 3% ung 5x/day
D/C when conjunctivitis has resolved (7-14 days)

Question 5

What is the Tx for HSK?

Answer 5

Ganciclovir 0.15% gel 5x/day
OR
Trifluridine 1% gtts 9x/day
OR 
Vidarabine 3% ung 5x/day
OR
Acyclovir 400mg 5x/day
*consider cycloplegia if A/C rxn or photophobia present
*NO topical steroids