Bilateral disciform keratitis: A rare entity

Incidence and Risk Factors of Bilateral Herpetic Keratitis: 2022 Update

“…The patient was treated with both oral and topical antiviral, and showed significant improvement. Herpetic disciform keratitis is a primary endotheliitis resulting in both stromal and epithelial edema in a round (disciform) distribution with keratic precipitates underlying the area of edema [4].…”

“…While Herpes Simplex Virus (HSV) can infect any part of the body and elicit a variety of serious diseases in humans, it commonly infects the face, genitals and eyes with skin/face infections, typically a consequence of either oral or ocular infection [1,2]. The virus is most commonly transmitted by droplets of infected secretions, such as tears and saliva, or by direct contact of skin sores [2,[4][5][6]. It was previously thought that HSV-1 had a predilection for the trigeminal ganglion and HSV-2 for the sacral ganglion [4,6].…”

“…The virus is most commonly transmitted by droplets of infected secretions, such as tears and saliva, or by direct contact of skin sores [2,[4][5][6]. It was previously thought that HSV-1 had a predilection for the trigeminal ganglion and HSV-2 for the sacral ganglion [4,6]. However, ocular infection can be caused by both HSV-1 and HSV-2 [2,3].…”

“…It can manifest as conjunctivitis, blepharitis, lid ulcers and vesicles with corneal signs seen in 33% patients. It often goes undiagnosed, especially when symptoms are mild [4,7].…”

“…Later, at any point in life, certain triggers promote HSV to reactivate. The virus then utilizes the host cell's DNA polymerase to transcribe and replicate [9], and finally it travels back down the nerve to cause a recurrent infection [4,7]. Weakening of the immune system and the presence of inflammatory mediators, such as cytokines, play an important role in the reactivation of HSV [10].…”