herpes simplex virus keratitis

Herpes simplex virus (HSV) keratitis is a viral infection of the eye caused by the herpes simplex virus, which affects the cornea and can also involve the iris. The symptoms and signs of HSV keratitis include:

• Foreign body sensation
• Eye pain or discomfort
• Sensitivity to light
• Blurred vision
• Small blisters around the eyelid

The hallmark of HSV keratitis is the presence of multiple small branching epithelial dendrites on the surface of the cornea. This condition can lead to corneal blindness and is a leading indication for corneal transplantation.

Herpes simplex keratitis is an eye infection that involves the cornea, which is the clear layer in front of the iris and pupil, and is caused by herpes simplex virus. It is the most common ocular manifestation of herpes simplex virus (HSV) eye infection, usually the HSV-1 subtype.

The symptoms may include a red eye, eye pain or foreign body sensation, sensitivity to light, blurred vision, and small blisters around the eyelid. These symptoms usually subside after about 2 weeks, but if left untreated, HSV keratitis can lead to serious complications, including corneal blindness.

References:

• [1] Herpes simplex keratitis is a viral infection of the eye caused by the herpes simplex virus (HSV). There are two major types of the virus.
• [3] The hallmark of HSV keratitis is the presence of multiple small branching epithelial dendrites on the surface of the cornea. Although often ...
• [5] Herpes simplex keratitis is an eye infection that involves the cornea (the clear layer in front of the iris and pupil) and is caused by herpes simplex virus.
• [6] Herpes simplex keratitis (HSK) is the most common ocular manifestation of herpes simplex virus (HSV) eye infection, usually the HSV-1 subtype.
• [8] Symptoms may include: · A red eye · Eye pain or foreign body sensation · Sensitivity to light · Blurred vision · Small blisters around the eyelid ...
• [9] by A Sugar · Cited by 7 — Keratitis (corneal infection and inflammation) caused by herpes simplex virus (HSV) is a major cause of blindness worldwide, due to corneal ...

Herpes simplex virus (HSV) keratitis is a viral infection that affects the cornea, leading to inflammation and potentially causing vision problems. The signs and symptoms of HSV keratitis can vary in severity and may include:

• Eye pain: A sharp, stabbing, or burning sensation in the eye [3][5]
• Redness: The eye becomes red, inflamed, and swollen due to increased blood flow [2][4]
• Photophobia: Sensitivity to light, making it uncomfortable for the person to be in bright environments [1][5]
• Blurred vision: Difficulty seeing clearly or a decrease in visual acuity [3][7]
• Tearing: Excessive tearing or discharge from the eye [2][4]
• Foreign body sensation: A feeling like there's something foreign or irritating in the eye [1][8]

In some cases, HSV keratitis can also cause more severe symptoms, such as:

• Blistering: Small blisters or ulcers may form on the surface of the cornea [6][8]
• Swollen eyelid: The eyelid may become swollen and inflamed due to the infection [6]

It's essential to seek medical attention if you experience any of these symptoms, as prompt treatment can help prevent long-term vision problems.

Herpes Simplex Virus (HSV) keratitis can be diagnosed through various clinical and laboratory tests.

Clinical Diagnosis The diagnosis of HSV keratitis is primarily based on the characteristic features of the corneal lesion, such as multiple arborizing dendritic epithelial ulcers with terminal bulbs [3]. A slit-lamp examination is mandatory to confirm the diagnosis in most cases [1].

Laboratory Tests While laboratory testing is not usually necessary for diagnosing HSV keratitis, certain tests can be used to confirm the presence of the virus. These include:

• Polymerase chain reaction (PCR) assay
• Enzyme-linked immunosorbent assay (ELISA)
• Immunofluorescent antibody test
• Viral culture

These tests can help confirm the diagnosis in cases where it is uncertain or when other conditions have similar symptoms [2, 4].

Other Diagnostic Methods In some cases, a swab of the infected area may be taken to identify the virus using viral culture or nucleic acid amplification techniques [4]. However, these methods are not usually necessary for diagnosing HSV keratitis.

It's worth noting that laboratory testing is not always required for diagnosing HSV keratitis, and the diagnosis can often be made based on clinical examination alone [5].

References: [1] Context 1 [2] Context 2 [3] Context 3 [4] Context 4 [5] Context 5

Herpes Simplex Virus (HSV) keratitis is a viral infection that affects the cornea, and its treatment typically involves antiviral medications.

Topical Antiviral Medications

• Trifluridine 1% eye drops are often prescribed to treat HSV keratitis. These drops can be applied eight to nine times a day to help manage the condition [6].
• Topical acyclovir and trifluridine have been shown to be effective in treating HSV epithelial keratitis, with trifluridine being a more potent inhibitor of viral growth [4][8].

Oral Antiviral Medications

• Acyclovir is a potent inhibitor of viral growth with minimal toxicity to uninfected epithelial cells. Oral acyclovir at a dose of 2 g/day for 10 days has been shown to be effective in treating HSV keratitis [3].
• Other oral antiviral medications, such as valacyclovir and famciclovir, are also used to treat HSV infections, including keratitis [9].

Combination Therapy

• In some cases, a combination of topical and systemic antiviral medications may be prescribed to treat HSV keratitis. This can help manage the condition more effectively [7].

It's worth noting that treatment with antiviral medications should only be initiated under the guidance of an eye care professional, as they can provide personalized advice based on the individual's specific needs.

References:

[3] Acyclovir is a potent inhibitor of viral growth with minimal toxicity to uninfected epithelial cells. Oral acyclovir at a dose of 2 g/day for 10 days has been shown to be effective in treating HSV keratitis. [4] Topical acyclovir and trifluridine have been shown to be effective in treating HSV epithelial keratitis, with trifluridine being a more potent inhibitor of viral growth. [6] Trifluridine 1% eye drops are often prescribed to treat HSV keratitis. These drops can be applied eight to nine times a day to help manage the condition. [7] Treatment is with topical or systemic antiviral medications. Herpes simplex keratitis usually affects the corneal surface but sometimes involves the corneal endothelium. [8] The best evidence from treatment trials on HSV epithelial keratitis supports the use of topical trifluridine and topical or oral acyclovir. [9] Antiviral agents for HSV infection include acyclovir, valacyclovir, and famciclovir. Metabolites of these nucleoside derivatives interfere with viral replication.

Herpes Simplex Virus (HSV) keratitis is a viral infection that affects the cornea, and its differential diagnosis involves considering various conditions that can present with similar symptoms. Here are some key points to consider:

• Contact lens-related keratitis: This condition can mimic HSV keratitis in terms of symptoms such as redness, discharge, and pain (1).
• Herpes zoster ophthalmicus: Also known as shingles, this viral infection can cause a rash on the eyelid or face, which may be mistaken for HSV keratitis (2).
• Other types of viral keratitis: Adenovirus, cytomegalovirus, and Epstein-Barr virus can all cause similar symptoms to HSV keratitis, making them important differential diagnoses (2).
• Recurrent epithelial erosion: This condition involves the repeated loss of the corneal epithelium, which may be mistaken for HSV keratitis due to its recurrent nature (3).
• Corneal abrasion: A scratch or injury to the cornea can cause symptoms similar to HSV keratitis, including pain and redness (3).
• Acanthamoeba keratitis: This rare but serious infection can cause symptoms such as pain, redness, and vision loss, which may be mistaken for HSV keratitis (4).

It's essential to consider these differential diagnoses when evaluating patients with suspected HSV keratitis. A thorough medical history, physical examination, and diagnostic tests such as slit-lamp examination and PCR testing can help differentiate between these conditions.

References:

(1) [1] (2) [2] (3) [3] (4) [4]