eye disorders
Herpes Simplex Keratitis
Treatment of Herpes Simplex Keratitis
Topicalganciclovirortrifluridine Oral or IVacyclovirorvalacyclovir For stromal involvement or uveitis, topical corticosteroids in addition to antiviral drugs Most patients are managed by an ophthalmologist. If stromal or uveal involvement occurs, treatment is more involved and referral to an ophthalmologist is mandatory. Dendritic (epithelial) keratitis can be treated with topical therapy (eg,ganciclovir0.15% gel applied every 3 hours while awake [5 times/day] ortrifluridine1% drops every 2 hours while awake [9 times/day]). Topical therapy is usually effective and is tapered off over 2 to 3 weeks. Alternatively, oral therapy (eg,acyclovir400 mg orally 3 to 5 times/day orvalacyclovir1000 mg orally twice/day) is also effective.Acyclovir400 mg orally twice/day orvalacyclovir500 to 1000 mg orally once/day may be prescribed as suppressive therapy to prevent frequent recurrences as well as to preserve eyesight in patients whose vision has been threatened. Immunocompromised patients may require IV antivirals (eg,acyclovir5 mg/kg IV every 8 hours for 7 days). but they may be effective when used with an antiviral to manage later-stage stromal involvement (disciform or stromal keratitis) or Overview of Uveitis . In such cases, patients may be given If the epithelium surrounding the dendrite is loose and edematous, debridement by gentle swabbing with a cotton-tipped applicator before beginning drug therapy may speed healing. Topical drugs to relieve photophobia includeatropine1% orscopolamine0.25% 3 times a day. 