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Herpes Simplex Keratitis
Aka: Herpes Simplex Keratitis, Herpes Keratitis, Herpes Simplex Conjunctivitis, HSV Conjunctivitis
- Epidemiology
- Outbreaks in winter and early summer
- Symptoms
- Previous history of Herpes Keratitis
- Coexisting Fever Blister on lip or upper face
- Recent Upper Respiratory Infection
- Absent history of Corneal Trauma
- Severe Eye Pain
- Photophobia
- Eye Discharge
- Gritty sensation in eye
- Signs
- Unilateral inflammation of Conjunctiva and Cornea
- Dendritic ulcers on Fluorescein staining of Cornea (consider rose bengal strips if available)
- Reduced Corneal sensitivity
- Preauricualar node (anterior to tragus)
- Complications
- Corneal Ulcer and scarring with obscured vision
- Management
- Urgent Ophthalmology referral
- Consider Hospital admission
- AVOID Topical Steroids
- Systemic Acyclovir or other antiviral agents
- Do not use topical Acyclovir due to to Corneal toxicity