Question

Discuss the clinical features of Herpes simplex keratitis.

Hint:

Herpes simplex keratitis is commonly diagnosed with fluorescein staining, which reveals the classic dendritic ulcers. Early detection and antiviral treatment are essential to prevent vision loss.

Answer 1

Step 1: Clinical Features of Herpes Simplex Keratitis.
Herpes simplex keratitis (HSK) is a viral infection of the cornea caused by the herpes simplex virus (HSV), typically resulting in unilateral eye involvement. The clinical features of HSK can range from mild to severe, and include:
(1) Pain and Photophobia: Patients often experience a painful, red eye with sensitivity to light (photophobi, which is one of the hallmark symptoms.
(2) Redness (Conjunctival Hyperemi: The conjunctiva may appear red and inflamed due to the viral infection.
(3) Corneal Dendritic Ulcers: The most characteristic sign of HSK is the presence of dendritic ulcers. These are branching lesions that can be seen with fluorescein staining under a slit-lamp examination. The ulcers are caused by the viral replication in the epithelial cells of the cornea.
(4) Decreased Vision: In more severe cases, corneal scarring, edema, or stromal involvement may lead to a decline in vision.
(5) Tearing and Discharge: Excessive tearing or mucopurulent discharge may also occur, particularly with secondary bacterial infection.
(6) Recurrent Episodes: HSK is often recurrent due to the latent nature of the HSV, with episodes triggered by stress, immunosuppression, or trauma.