Conjunctival herpetic ulcer in an immunosuppressed patient with birdshot chorioretinopathy

Abstract

Introduction: Herpes Simplex Virus (HSV) is a human herpesvirus responsible for systemic infections. Ocular involvement spans all ocular tissues. Corneal lesions, such as dendritic or geographic ulcers, are frequently found in HSV keratitis while conjunctival lesions have been described as infrequent.
 Clinical case: A 62-year-old man diagnosed with Birdshot chorioretinopathy presented a stye in his eyelid that was treated with oxytetracycline-hydrocortisone ointment. One week later he returned presenting several small dendritic corneal ulcers in both eyes and a conjunctival ulcer in one of them. All lesions healed completely after treatment with topical acyclovir ophthalmic ointment at 3%.
 Conclusions: We should pay attention to the conjunctiva and not merely focus on the cornea when examining patients with herpetic eye disease, especially if being treated with inmunosupressors.