Ophthalmology - Herpes Keratitis Flashcards
What does keratitis refer to?
Inflammation of the cornea
What causes of keratitis?
- Viral infection (e.g., herpes simplex)
- Bacterial infection (e.g., Pseudomonas or Staphylococcus)
- Fungal infection (e.g., Candida or Aspergillus)
- Contact lens-induced acute red eye (CLARE)
- Exposure keratitis
What causes exposure keratitis?
Inadequate eyelid coverage (e.g., ectropion)
What is the most common cause of keratitis?
Herpes simplex virus (HSV) infection
What is herpes simplex keratitis?
Keratitis caused by herpes simplex virus
Can affect any part of the eye but mostly affects epithelial layer of the cornea
What are the two types of herpes simplex keratitis?
- Primary
- Recurrent - HSV travels to trigeminal ganglion where it becomes latent and can reactivate late
What is stromal keratitis?
Inflammation of the stromal layer of the cornea (between the epithelium and endothelium)
What complications are associated with stromal keratitis?
- Stromal necrosis
- Vascularisation
- Scarring
- Corneal blindness
What are typical symptoms of primary herpes simplex keratitis?
Mild symptoms of blepharoconjunctivitis
List some symptoms of recurrent herpes simplex keratitis
- Painful red eye
- Photophobia
- Vesicles (fluid-filled blisters)
- Foreign body sensation
- Watery discharge
- Reduced visual acuity
What examination is required to diagnose keratitis?
Slit lamp examination
Fluorescein stain shows dendritic corneal ulcer
Dendric describes branching of the ulcer
Corneal scrapings can be used for viral testing
What types of antivirals are used in the management of herpes simplex keratitis?
- Topical antivirals (e.g., aciclovir)
- Oral antivirals (e.g., ganciclovir)
What is a treatment option for permanent scarring and vision loss after keratitis?
Corneal transplant
