Herpes simplex keratitis: challenges in diagnosis and clinical management

Figures & data

Figure 1 Representative images of various corneal damages due to HSV1 infection.

Notes: (A) Large herpetic epithelial dendrite at graft–host junction. (B) Large subepithelial bulla due to HSV endotheliitis. (C) Ring-lipid deposit surrounding a focal HSV disciform keratitis. (D) Large geographic herpetic ulcer in HIV patient. (E) Herpetic keratouveitis with anterior chamber inflammation (layered hypopyon due to WBC accumulation), small keratic precipitates (WBC aggregates on the corneal endothelial surface), and corneal edema (due to endothelial dysfunction). (F) Large herpetic epithelial dendrite. (G) Postherpetic neurotrophic epithelial defect due to corneal nerve damage by HSV1. (H) Large herpetic corneal scar with iris incarceration to the side of corneal perforation.
Abbreviations: HSV, herpes simplex virus; WBC, white blood cell.

Table 1 Summary of current treatment for different subtypes

Subgroup	Treatment
Epithelial subtype	Antiviral agents^Citation13
Stromal subtype	Combination of topical corticosteroids and antiviral agents^Citation27
Endothelial subtype	Combination of topical corticosteroids and antiviral agents^Citation50

WilhelmusKRAntiviral treatment and other therapeutic interventions for herpes simplex virus epithelial keratitisCochrane Database Syst Rev20151CD00289825879115

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KnickelbeinJEHendricksRLCharukamnoetkanokPManagement of herpes simplex virus stromal keratitis: an evidence-based reviewSurv Ophthalmol200954222623419298901

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HillGMKuESDwarakanathanSHerpes simplex keratitisDis Mon201460623924624906668

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