Herpes simplex keratitis: Difference between revisions
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{{Infobox medical condition | |||
| name = Herpes simplex keratitis | |||
| image = [[File:Dendritic_corneal_ulcer.jpg|left|thumb|Dendritic corneal ulcer]] | |||
| caption = Dendritic corneal ulcer caused by herpes simplex virus | |||
| field = [[Ophthalmology]] | |||
| synonyms = Herpetic keratitis | |||
| symptoms = [[Eye pain]], [[redness of the eye]], [[blurred vision]], [[photophobia]], [[tearing]] | |||
| complications = [[Corneal scarring]], [[vision loss]], [[corneal perforation]] | |||
| onset = Sudden | |||
| duration = Varies, can be recurrent | |||
| causes = [[Herpes simplex virus]] (HSV-1, rarely HSV-2) | |||
| risks = [[Immunosuppression]], [[stress]], [[UV light exposure]] | |||
| diagnosis = [[Slit lamp examination]], [[fluorescein staining]] | |||
| differential = [[Bacterial keratitis]], [[fungal keratitis]], [[acanthamoeba keratitis]] | |||
| treatment = [[Antiviral medication]] (e.g., [[acyclovir]], [[ganciclovir]]), [[topical corticosteroids]] (with caution) | |||
| prognosis = Good with treatment, but recurrences are common | |||
| frequency = Common | |||
}} | |||
= Herpetic Simplex Keratitis = | = Herpetic Simplex Keratitis = | ||
[[File:Herpes keratitis -- intermed mag.jpg|left|thumb|A clinical image showing the characteristic dendritic ulcer of Herpetic Simplex Keratitis.]] | |||
[[File:Herpes keratitis -- intermed mag.jpg|thumb | |||
'''Herpetic simplex keratitis''' is an ocular disease caused by the [[Herpes simplex virus|herpes simplex virus (HSV)]] that affects the [[Cornea|cornea]], the clear front part of the eye. It is a recurrent condition that can lead to varying degrees of corneal damage. | '''Herpetic simplex keratitis''' is an ocular disease caused by the [[Herpes simplex virus|herpes simplex virus (HSV)]] that affects the [[Cornea|cornea]], the clear front part of the eye. It is a recurrent condition that can lead to varying degrees of corneal damage. | ||
== Etiology and Pathophysiology == | == Etiology and Pathophysiology == | ||
HSV is a widespread pathogen known to cause a variety of infections. In the context of herpetic simplex keratitis, the virus specifically targets the corneal epithelium. Following an initial or primary infection, the virus can enter a latent state within the nerves. Reactivation can occur due to various triggers, leading to recurrent episodes of the disease. | HSV is a widespread pathogen known to cause a variety of infections. In the context of herpetic simplex keratitis, the virus specifically targets the corneal epithelium. Following an initial or primary infection, the virus can enter a latent state within the nerves. Reactivation can occur due to various triggers, leading to recurrent episodes of the disease. | ||
[[File:Cytology corneal herpes multinucleated cell.jpeg|left|thumb|The structure of HSV and its infection cycle.]] | |||
[[File:Cytology corneal herpes multinucleated cell.jpeg|thumb | |||
== Clinical Presentation == | == Clinical Presentation == | ||
=== Initial Symptoms === | === Initial Symptoms === | ||
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The primary infection often manifests as [[Conjunctivitis|blepharoconjunctivitis]], characterized by swollen eyelids and conjunctiva, and may be accompanied by small, itchy lesions on the surface of the cornea. | The primary infection often manifests as [[Conjunctivitis|blepharoconjunctivitis]], characterized by swollen eyelids and conjunctiva, and may be accompanied by small, itchy lesions on the surface of the cornea. | ||
[[File:Herpes simplex geographic corneal ulcer.jpeg|left|thumb|Eyelid swelling in a patient with herpetic simplex keratitis.]] | |||
[[File:Herpes simplex geographic corneal ulcer.jpeg|thumb | |||
=== Corneal Manifestations === | === Corneal Manifestations === | ||
As the infection progresses, the surface of the eye can develop superficial punctate keratitis, where the corneal epithelium is dotted with minute lesions. In more severe cases, dendritic ulcers can form, which are distinctive in their branching pattern and are a hallmark of herpetic simplex keratitis. | As the infection progresses, the surface of the eye can develop superficial punctate keratitis, where the corneal epithelium is dotted with minute lesions. In more severe cases, dendritic ulcers can form, which are distinctive in their branching pattern and are a hallmark of herpetic simplex keratitis. | ||
=== Unilateral Presentation === | === Unilateral Presentation === | ||
Herpetic simplex keratitis usually affects only one eye at a time, though bilateral cases can occur, especially in individuals with compromised immune systems. | Herpetic simplex keratitis usually affects only one eye at a time, though bilateral cases can occur, especially in individuals with compromised immune systems. | ||
== Symptoms == | == Symptoms == | ||
Patients with herpetic simplex keratitis may report a range of symptoms including: | Patients with herpetic simplex keratitis may report a range of symptoms including: | ||
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* The feeling of having a foreign body in the eye | * The feeling of having a foreign body in the eye | ||
* Photophobia (light sensitivity) | * Photophobia (light sensitivity) | ||
== Diagnosis == | == Diagnosis == | ||
Diagnosis is primarily clinical but can be supplemented by laboratory tests such as viral culture, polymerase chain reaction (PCR), or serological tests to detect the presence of HSV. | Diagnosis is primarily clinical but can be supplemented by laboratory tests such as viral culture, polymerase chain reaction (PCR), or serological tests to detect the presence of HSV. | ||
== Treatment == | == Treatment == | ||
Treatment typically involves antiviral medication to reduce the severity and frequency of outbreaks. In cases where corneal scarring occurs, further interventions such as [[corneal transplant]] may be necessary. | Treatment typically involves antiviral medication to reduce the severity and frequency of outbreaks. In cases where corneal scarring occurs, further interventions such as [[corneal transplant]] may be necessary. | ||
== Complications and Management == | == Complications and Management == | ||
If left untreated, herpetic simplex keratitis can lead to complications like corneal scarring, thinning, and even perforation, which might necessitate corneal transplantation. Regular follow-ups and education on the importance of early treatment during recurrences are critical components of patient management. | If left untreated, herpetic simplex keratitis can lead to complications like corneal scarring, thinning, and even perforation, which might necessitate corneal transplantation. Regular follow-ups and education on the importance of early treatment during recurrences are critical components of patient management. | ||
== Preventive Measures == | == Preventive Measures == | ||
Preventive strategies may include the use of antiviral prophylaxis, particularly in patients with frequent recurrences, and the management of known triggers such as ultraviolet light exposure. | Preventive strategies may include the use of antiviral prophylaxis, particularly in patients with frequent recurrences, and the management of known triggers such as ultraviolet light exposure. | ||
== See Also == | == See Also == | ||
* [[Cornea]] | * [[Cornea]] | ||
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* [[Immunology]] | * [[Immunology]] | ||
* [[Ophthalmology]] | * [[Ophthalmology]] | ||
== References == | == References == | ||
<references/> | <references/> | ||
== External Links == | == External Links == | ||
* [https://www.aoa.org/ American Optometric Association] | * [https://www.aoa.org/ American Optometric Association] | ||
* [https://www.aao.org/ American Academy of Ophthalmology] | * [https://www.aao.org/ American Academy of Ophthalmology] | ||
[[Category:Eye diseases]] | [[Category:Eye diseases]] | ||
[[Category:Viral diseases]] | [[Category:Viral diseases]] | ||
[[Category:Herpes]] | [[Category:Herpes]] | ||
[[Category:Ophthalmology]] | [[Category:Ophthalmology]] | ||
{{stub}} | {{stub}} | ||
Latest revision as of 04:32, 7 April 2025
Editor-In-Chief: Prab R Tumpati, MD
Obesity, Sleep & Internal medicine
Founder, WikiMD Wellnesspedia &
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| Herpes simplex keratitis | |
|---|---|
 | |
| Synonyms | Herpetic keratitis |
| Pronounce | N/A |
| Specialty | N/A |
| Symptoms | Eye pain, redness of the eye, blurred vision, photophobia, tearing |
| Complications | Corneal scarring, vision loss, corneal perforation |
| Onset | Sudden |
| Duration | Varies, can be recurrent |
| Types | N/A |
| Causes | Herpes simplex virus (HSV-1, rarely HSV-2) |
| Risks | Immunosuppression, stress, UV light exposure |
| Diagnosis | Slit lamp examination, fluorescein staining |
| Differential diagnosis | Bacterial keratitis, fungal keratitis, acanthamoeba keratitis |
| Prevention | N/A |
| Treatment | Antiviral medication (e.g., acyclovir, ganciclovir), topical corticosteroids (with caution) |
| Medication | N/A |
| Prognosis | Good with treatment, but recurrences are common |
| Frequency | Common |
| Deaths | N/A |
Herpetic Simplex Keratitis[edit]
Herpetic simplex keratitis is an ocular disease caused by the herpes simplex virus (HSV) that affects the cornea, the clear front part of the eye. It is a recurrent condition that can lead to varying degrees of corneal damage.
Etiology and Pathophysiology[edit]
HSV is a widespread pathogen known to cause a variety of infections. In the context of herpetic simplex keratitis, the virus specifically targets the corneal epithelium. Following an initial or primary infection, the virus can enter a latent state within the nerves. Reactivation can occur due to various triggers, leading to recurrent episodes of the disease.
Clinical Presentation[edit]
Initial Symptoms[edit]
The primary infection often manifests as blepharoconjunctivitis, characterized by swollen eyelids and conjunctiva, and may be accompanied by small, itchy lesions on the surface of the cornea.
Corneal Manifestations[edit]
As the infection progresses, the surface of the eye can develop superficial punctate keratitis, where the corneal epithelium is dotted with minute lesions. In more severe cases, dendritic ulcers can form, which are distinctive in their branching pattern and are a hallmark of herpetic simplex keratitis.
Unilateral Presentation[edit]
Herpetic simplex keratitis usually affects only one eye at a time, though bilateral cases can occur, especially in individuals with compromised immune systems.
Symptoms[edit]
Patients with herpetic simplex keratitis may report a range of symptoms including:
- Deep dull pain within the eye
- Sensation of dryness and irritation
- Reduced visual acuity
- The feeling of having a foreign body in the eye
- Photophobia (light sensitivity)
Diagnosis[edit]
Diagnosis is primarily clinical but can be supplemented by laboratory tests such as viral culture, polymerase chain reaction (PCR), or serological tests to detect the presence of HSV.
Treatment[edit]
Treatment typically involves antiviral medication to reduce the severity and frequency of outbreaks. In cases where corneal scarring occurs, further interventions such as corneal transplant may be necessary.
Complications and Management[edit]
If left untreated, herpetic simplex keratitis can lead to complications like corneal scarring, thinning, and even perforation, which might necessitate corneal transplantation. Regular follow-ups and education on the importance of early treatment during recurrences are critical components of patient management.
Preventive Measures[edit]
Preventive strategies may include the use of antiviral prophylaxis, particularly in patients with frequent recurrences, and the management of known triggers such as ultraviolet light exposure.
See Also[edit]
- Cornea
- Virus
- Eye infection
- Conjunctivitis
- Corneal ulcer
- Dry eye syndrome
- Sinusitis
- Immunology
- Ophthalmology
References[edit]
<references/>
