Bilateral herpetic keratitis.

Wilhelmus, Kirk R.; Falcon, M G; Jones, Barrie R.

doi:10.1136/bjo.65.6.385

Cited by 65 publications

(24 citation statements)

References 8 publications

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“…Examination detected epithelial lesions in the centre of the cornea in the right eye (Fig 2) and at 11 clock hours in the periphery of the left eye 2…”

Section: Casementioning

confidence: 99%

Herpes simplex dendritic keratitis after treatment with latanoprost for primary open angle glaucoma

Ekatomatis

2001

British Journal of Ophthalmology

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“…Examination detected epithelial lesions in the centre of the cornea in the right eye (Fig 2) and at 11 clock hours in the periphery of the left eye 2…”

Section: Casementioning

confidence: 99%

Herpes simplex dendritic keratitis after treatment with latanoprost for primary open angle glaucoma

Ekatomatis

2001

British Journal of Ophthalmology

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“…This enables them to be differentiated from corneal ulcers due to other causes, and their clinical diagnosis as herpetic keratitis. Sometimes, however, such factors as duration since onset, previous medication, systemic diseases (atopic dermatitis,1 for example), or history of corneal transplantation2 can make the epithelial lesions appear different from classic HSV lesions. The initial diagnosis is very important, since it decides the use of antiviral drugs, such as aciclovir.…”

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Detection of herpes simplex virus DNA in atypical epithelial keratitis using polymerase chain reaction

Koizumi

Nishida

Adachi

et al. 1999

British Journal of Ophthalmology

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Aim-To study herpes simplex virus (HSV) DNA in tears from patients with atypical epithelial keratitis of unknown aetiology. Methods-Tear samples were collected from 17 aVected eyes of 17 consecutive patients suVering from epithelial keratitis in whom HSV keratitis was suspected but whose diagnosis was diYcult on the basis of clinical manifestations alone. Using reduced sensitivity polymerase chain reaction (PCR), tear samples were tested for HSV DNA. Tears from the unaVected eyes of the 17 patients were also examined, along with 38 tear samples from 19 normal volunteers. Southern blot analysis was performed to confirm that amplified DNA bands were specific for HSV. Clinical correlation with photographs of corneal lesions was also investigated. Results-HSV DNA was detected in tears from the aVected eyes of eight of the 17 patients with suspected HSV keratitis. Tears from the aVected eyes of the other patients were PCR negative, as were tears from the unaVected eyes of all 17 patients, and from the 38 normal eyes. There was no correlation between PCR results and clinical manifestation of keratitis. Conclusions-Based on the sensitivity of the PCR system, eight of 17 suspected HSV keratitis patients were confirmed as suVering from HSV keratitis. HSV keratitis should therefore be considered as a possible diagnosis in atypical epithelial keratitis. (Br J Ophthalmol 1999;83:957-960) Herpes simplex virus (HSV) epithelial keratitis, a leading cause of corneal blindness, is typified by dendritic or geographical corneal ulcers, which usually have dendritic edges with terminal bulbs and epithelial infiltration. This enables them to be diVerentiated from corneal ulcers due to other causes, and their clinical diagnosis as herpetic keratitis. Sometimes, however, such factors as duration since onset, previous medication, systemic diseases (atopic dermatitis, 1 for example), or history of corneal transplantation 2 can make the epithelial lesions appear diVerent from classic HSV lesions. The initial diagnosis is very important, since it decides the use of antiviral drugs, such as aciclovir. In atypical cases, however, it is often diYcult to make a correct diagnosis based solely on the clinical presentation.Since Saiki et al's 1985 report on the usefulness of the polymerase chain reaction (PCR) for diagnostic purposes, 3 it has often been used for diagnosing viral diseases of the eye. [4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22] Previously, we established a reduced sensitivity PCR for diagnosing HSV epithelial keratitis, [4][5][6][7] corneal endothelitis, 8 and HSV related uveitis.9 10 Using this PCR system, we are able to detect HSV DNA in tears from patients with clinically diagnosed HSV epithelial keratitis. The sensitivity of this system is higher than that of viral culture, while being low enough not to give a positive PCR result in normal tears. 4 5 In the present study, we used the reduced sensitivity PCR system to investigate HSV DNA in tears from suspected epithelial keratitis patie...

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“…In Table 5 Clinical appearance ofactive corneal ulceration due to herpes simplex virus in 47 34 contrast herpetic corneal ulceration followed measles in only 21% of cases, was bilateral in only 23% of cases, and was associated with significantly lower mortality (6%) and blindness (2%) ( Table 6). …”

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Corneal ulceration, measles, and childhood blindness in Tanzania.

Foster¹,

Sommer²

1987

British Journal of Ophthalmology

113

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SUMMARY One hundred and thirty Tanzanian children with corneal ulceration were clinically examined to determine the cause of the ulceration. 37% of the ulcers were associated with recent measles infection and 38% of the children had bilateral ulceration. Herpes simplex virus infection was the commonest cause of ulceration in the series, but vitamin A deficiency was the major cause of bilateral ulceration, subsequent blindness, and mortality in this series. Other significant causes of childhood corneal ulceration were the use of traditional eye medicines, confluent measles keratitis, and ophthalmia neonatorum. We discuss the various mechanisms by which measles causes corneal ulceration, and the priorities in prevention and management of corneal ulceration in African children.Xerophthalmia, a term used to describe the ocular findings caused by vitamin A deficiency, remains one of the six commonest blinding diseases in the world today and the commonest cause of blindness in children.' 2 The problem of childhood blindness due to xerophthalmia has been well established in Indonesia3 and other parts of Asia."7 In Africa, however, although 70% of blind school children are blind from corneal scarring,""' there is still uncertainty over the relative importance and interaction of factors such as measles infection," vitamin A deficiency, 2-8 herpes simplex keratitis,"' " and the use of traditional eye medicines82122 in causing childhood ulceration and corneal blindness.To investigate this problem we carried out a hospital based study with the aim of identifying by clinical means: (1) the major causes of corneal ulceration in Tanzanian children, (2) the mechanisms by which measles may lead to corneal ulceration, and (3) the major pathways leading to blindness from corneal scarring in children. Patients and methodsOne of us (AF) examined 130 children aged 4 days to 10 years presenting with corneal ulceration to the eye All the children were admitted to hospital and basic demographic and historical information documented on a standard form. This included name, age, sex, village of residence, date ulcer first noted, history of measles, use of traditional eye medicines, recent diet, and history of night blindness. Ocular examination with a handlight, lid speculum, fluorescein, and, in co-operative children, slit-lamp microscopy was performed, and photographs were taken of the corneal ulcers. Nutritional status was determined by comparing their weight for age against the Harvard standards. The child was considered normal (well nourished) if his weight for age was greater than 80% of standard, underweight if 60-80% of standard, and marasmic if less than 60% weight for age.For this special investigation serum samples were drawn for chemical analysis on 41 consecutive cases of the 130 cases in this report. They were also obtained from three controls for each of the children with a diagnosis of measles-associated xerophthalmic corneal ulceration, matched on age, sex, and the presence of measles. The serum was kept frozen until shipm...

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Bilateral herpetic keratitis.

Cited by 65 publications

References 8 publications

Herpes simplex dendritic keratitis after treatment with latanoprost for primary open angle glaucoma

Herpes simplex dendritic keratitis after treatment with latanoprost for primary open angle glaucoma

Detection of herpes simplex virus DNA in atypical epithelial keratitis using polymerase chain reaction

Corneal ulceration, measles, and childhood blindness in Tanzania.

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