Herpes simplex keratitis

Herpes simplex keratitis is inflammation of the cornea caused by herpes simplex virus. It can affect the corneal epithelium, stroma, or deeper tissues and may threaten vision through scarring.

Herpes simplex virus: Herpes simplex viruses are DNA viruses that establish lifelong latent infections in sensory neurons and can reactivate. Reactivation in the ophthalmic sensory pathway can return virus to the cornea.
Fluorescein stain: A diagnostic dye that highlights defects in the corneal epithelium under blue light. It reveals the branching epithelial defects typical of active epithelial disease.
Acanthamoeba keratitis: A painful corneal infection caused by Acanthamoeba, an amoeba found in water and soil. Its ring infiltrate and exposure history can distinguish it from herpes disease.
Corneal scarring: Permanent fibrous opacity in the cornea caused by injury, infection, or inflammation. Stromal inflammation can leave opacity that reduces visual clarity.
Dendritic ulcer: A branching corneal epithelial ulcer with terminal bulbs, classically associated with herpes simplex infection. This characteristic lesion marks epithelial viral replication.
Slit lamp: An ophthalmic microscope that provides magnified, illuminated views of the eye’s structures. It helps locate inflammation and assess corneal depth.
Bacterial keratitis: Corneal infection caused by bacteria, often producing an ulcer and inflammatory response. Bacterial ulcers can resemble herpetic lesions but need antibacterial treatment.
Corneal neovascularization: The abnormal growth of blood vessels into the normally avascular cornea. Chronic inflammation can draw vessels into the cornea and compromise transparency.
Neurotrophic keratopathy: A degenerative corneal disorder caused by impaired sensory innervation, leading to poor epithelial healing. Herpes-related nerve damage can impair corneal sensation and healing.
Acyclovir: An antiviral drug that inhibits herpesvirus DNA replication after activation in infected cells. It is used to treat or suppress herpes simplex eye disease.

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