Herpes Simplex Keratitis: Bilateral Effects.

Abstract

disease. 2 It is plausible that viral reactivation occurred in both trigeminal ganglia and possibly the cornea, resulting in the presence of virus in both clinically affected and fellow eyes. The absence of clinically recognizable disease in fellow eyes would support the differences in nerve count, sensation, and ECD between affected and contralateral eyes. What is important about this study is the demonstration of the bilateral effects of HSK particularly in terms of ECD and corneal innervation. These bilateral effects of clinical unilateral HSK raise significant issues regarding treatment, prophylaxis, and management, particularly with regard to consideration of greater use of systemic antiviral therapy. Future work would be to longitudinally sample for HSV-1 and image the affected and unaffected areas of the cornea in the affected and fellow eyes, including other measurements of sensation in addition to mechanical touch such as temperature and chemical stimuli, which may be selectively altered in HSK. 4