Ocular Viral Infections Research Articles

Ocular Viral Infections

The most important viral organisms involving the eye are the DNA viruses herpes simplex, varicella-zoster, cytomegalovirus, adenovirus, and vaccinia virus. All of these agents except CMV may cause acute epithelial infection, sterile trophic ulceration due to basement membrane damage, deep corneal stromal immune reaction, and iritis. Although there are three excellent antiviral drugs commercially available, only HSV and vaccinia virus are highly sensitive to therapy with these antimetabolites; varicella-zoster virus and CMV are equivocally responsive and adenovirus has not been shown to be susceptible to these agents. In selected situations, topical or systemic corticosteroids are useful for managing any associated immune reactions in the eyes, but patients on these drugs should be monitored carefully both for superinfections and for interference with tissue healing that might ultimately threaten the integrity of the globe.

Electron Microscopy for the Diagnosis of Ocular Viral Infections

Tear samples obtained from patients with suspected viral conjunctivitis were examined by virus culture and by the pseudoreplica method of electron microscopy (EM). Adenoviruses were isolated in 13 of the 34 cases (38%) clinically diagnosed as adenovirus conjunctivitis. Characteristic adenoviral particles were demonstrated by electron microscopy in seven of the culture-positive, and two of the culture-negative samples. In cases of herpes simplex virus ocular infection, tears were virus positive by culture in one-third of the patients; two-thirds of the culture positive specimens were also positive by EM. This study demonstrates the potential of electron microscopy as a rapid, specific, and relatively inexpensive method for the laboratory diagnosis of ocular viral infections.

Methods for Rapid Detection of Human Ocular Viral Infections

Recent methods for detection of viruses in clinical specimens include immunofluorescence, immunoperoxidase, immune adherence hemagglutination, radioimmunoassay, enzyme-linked immunosorbent assay (ELISA), and immunoelectron microscopy. Some are useful for the detection of traces of viral antigens but are more complicated and timeconsuming than others. Simple techniques of immunofluorescence and negative stain electron microscopy are used for the rapid detection of viruses in human adenoviral, herpetic, rubella, molluscum contagiosum, and vaccinial infections.

Ocular Antiviral Therapy in Perspective

The eye presents a unique model for the study of the pathogenesis of viral disease, drugs, and local and general host factors. Disease is easily observed and quantitated, and the presence of two organs sometimes permits controlled observations that are otherwise impossible. Perhaps most important, ocular viral infection is disabling and blinding, and the success of its treatment with antiviral drugs has clearly demonstrated the potential for the use of antiviral drugs in other areas.

Difference in Interferon Response and Protection from Ocular Virus Infection in Rabbits and Monkeys

Difference in Interferon Response and Protection from Ocular Virus Infection in Rabbits and Monkeys