Midterm 2: Herpes Simplex Virus and Zoster Flashcards
What virus is the leading cause of infectious corneal blindness in all developed countries?
Herpes Simplex Virus
Is Herpes Simplex usually unilateral or bilateral?
Unilateral (Almost always)
Is type 1 or type 2 herpes simplex most associated with ocular diagnoses?
Type 1 (Type 2 genital/sexual transmitted)
Who are the most common patients for primary herpes simplex?
School-aged children
In primary herpes simplex, are symptoms common or uncommon?
Uncommon, 94% patients are asymptomatic.
What are 4 ocular signs of primary herpes simplex-1?
1) Pre-auricular node swelling
2) Vesicular rash
3) Follicular conjunctivitis
4) (rare) multiple corneal punctate lesions (dendrite)
What layer of the cornea will you find primary HSV-1 vesicles?
Epithelium
True or false:
you can have ocular involvement with primary HSV-1.
True but it is very rare
Where does HSV-1 get stored when it is latent?
Trigeminal and dorsal root ganglion
What do you call recurrent HSV-1when it has ocular involvement?
Herpes Simplex Keratitis
What symptoms will a patient have with Herpes Simplex Keratitis? (6)
Pain/ocular discomfort
Photophobia
Watering
Itching
Decreased vision/ blurry vision
Corneal Desensitization
What main sign will signify Herpes Simplex Keratitis?
Dendritic Keratitis
What are the 3 different types of Herpes Simplex Keratitis (HSK)? What is most common?
1) HSK- epithelial (most common)
2) HSK-Stromal
3) Endotheliitis
What can you use to stain Herpes Simplex Keratitis (HSK)?
Fluorescein (center)
Lissamine green and Rose bengal (edges)
What can you use to stain Herpes Simplex Keratitis (HSK)?
Fluorescein (center)
Lissamine green and Rose bengal (edges)
Who are more susceptible to getting HSK-epithelial: Geographic keratitis?
Immune compromised
Misdiagnosed (receive steroid and come back later only to find it has spread larger)
Describe HSK-Epithelial: Neurotrophic Keratits
Vision threatening
stromal involvement erodes epithelium
smooth round border
rapid progression
patient desensitized (false sense of getting better)
Is stromal keratitis necrotizing or non-necrotizing? When does it occur?
Non-necrotizing
Occurs after HSK epithelial
What kind of keratitis is HSV stromal that is necrotizing?
Interstitial keratitis
What is HSK-endothelial: Endotheliitis typically in tandem with? What sign is found with this diagnoses?
Usually in tandem with Disciform
Endothelial folds/edema often found
What HSK is more likely to require a corneal transplant?
HSK-endothelial: Endotheliitis
What are 2 HSK complications?
-Corneal desensitization (hypoesthesia) especially in stroma
-Corneal scarring
-uveitis
-scleritis more often than episcleritis retinitis
optic neuritis
