Abstract
AbstractIn Europe, herpes simplex virus type I (HSV) is a common cause of keratitis. The disease may be well treated if the ophthalmologist is aware of the various types of clinical expressions of this typical unilateral chameleon, and treatment is adjusted accordingly. Types of expression include 1. epithelial keratitis (dendritica/ geographica), 2. stromal keratitis (necrotizing “ulcer” “vs. non‐necrotizing = interstitial keratitis”), 3. endotheliitis (= “disciform keratitis”), 4. so‐called “metaherpetic keratitis” (= neurotrophic keratopathy), 5. (vascularized) corneal scars. In the acute phase, concomitant ocular hypertension should be treated predominantly without surgery (no prostaglandin analoga!). After keratoplasty and in case of severe recurrences of herpetic keratitis, systemic acyclovir application (2 × 400 mg/day) for at least 1 year is indispensable! In 1.5% of corneal excisions during keratoplasty, HSV PCR is positive without clinical suspicion of herpetic keratitis. This may be one reason for primary or secondary graft failure and needs adequate treatment.
Published Version
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