Herpes Simplex KeratitisOphthalmology and Visual Sciences. WelderMD, Anna S. KitzmannMD, Michael D. WagonerMD, PhD. There herpes simplex keratitis treatment with valtrex no history of trauma. The ETC physician performed fluorescein staining and made a diagnosis of a corneal abrasion. She was instructed to follow-up with her eye care provider the next day if symptoms did not improve or resolve.
Treating HSV keratitis | Ophthalmology Magazine
A variety of factors have been reported as inducing the reactivation of latent herpes simplex virus HSV , among them stress, trauma, and UV radiation. Excimer laser photorefractive keratectomy PRK is a surgical procedure utilizing a nm ultraviolet light to alter the curvature of the cornea and hence correct vision. Reactivation of ocular herpes simplex keratitis following such excimer laser PRK has been reported. All published cases of HSV reactivation following excimer laser treatment in humans are reviewed.
The present study evaluates whether stress, trauma of the corneal de-epithelialization prior to the laser, or the excimer laser treatment itself to the stromal bed induces this ocular reactivation of the latent HSV, and whether a systemic antiviral agent, valacyclovir, would prevent such laser PRK-induced reactivation of the HSV. The animals were monitored until resolution, and then all animals were divided into 5 treatment groups: Animals were evaluated in a masked fashion by clinical examination biweekly and viral cultures biweekly through day The reactivation rates were as follows: Viral titers were negative in animals that had no reactivation but persistently positive in those that had reactivation day 6 through day De-epithelialization alone is not sufficient to cause reactivation or viral shedding.
Prophylaxis with intraperitoneal valacyclovir decreases the recurrence rate in a dose-response fashion. The presence of persistent viral shedding in reactivated animals may correlate with cases of late HSV recurrence reported in humans undergoing excimer treatment. The data suggest that humans undergoing excimer laser procedures for correction of refractive errors or treatment of corneal scars with a history of herpetic keratitis are at increased risk for reactivation.
Such patients, however, may appropriately be considered for prophylactic systemic antiviral medication at the time of the laser procedure in order to decrease the possibility of recurrence. National Center for Biotechnology Information , U. Trans Am Ophthalmol Soc. This article has been cited by other articles in PMC. Dawson CR, Togni B. Herpes simplex eye infections: Herpes simplex keratitis in a developing country.
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