Herpes Simplex Keratitis
Herpes simplex keratitis is infection of the cornea caused by herpes simplex virus.
When herpes simplex keratitis (herpes simplex keratoconjunctivitis (see Section 17, Chapter 198)) begins, the symptoms may resemble a mild bacterial infection: the eyes are slightly painful, watery, red, and sensitive to bright light. Rarely, the infection worsens and the cornea swells, making vision hazy.
Most often, the initial infection produces only mild changes in the cornea and goes away without treatment. However, sometimes the infection returns and symptoms worsen. If the infection recurs, further damage to the surface of the cornea may result. Several recurrences may result in the formation of deep ulcers, permanent scarring, and a loss of feeling when the eye is touched. The herpes simplex virus can also cause blood vessels to grow onto the cornea and, occasionally, can lead to significant visual impairment. To diagnose a herpes simplex infection, a doctor examines the eye with a slit lamp. (see Section 20, Chapter 225) Sometimes, the doctor may take a sample from the infected area to identify the virus (viral culture).
The doctor may prescribe an antiviral drug, such as trifluridine eye drops or vidarabine ointment. Acyclovir, an antiviral drug, can be taken by mouth. Treatment should be started as soon as possible. Occasionally, to help speed healing, after numbing the eye, an ophthalmologist may have to gently swab the cornea with a soft cotton-tipped applicator to remove infected and damaged cells.
|
