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It is a primary, superficial, infective ulcer having a dendritic shape caused by Herpes Simplex Virus (epitheliotropic type).
Dendritic ulcer stained with fluorescin
Herpes Simplex virus
Primarily responsible, above waist Orofacial & ocular infection HSV-1 Transmitted sexually Genital diseases, passed to neonates HSV-2
Virus becomes dormant in trigeminal (V) ganglion Inter-neuronal spread 1ry HSV-1 infection; in childhood Direct contact of skin or mucous membrane with virus-laden lesions or secretions
Fever Menstruation Drugs Psychic stress Low resistance
Recurrence occurs with decreased body resistance Virus becomes active Vesicles in mouth, genitalia, cornea
Close-up view of early herpes outbreak shows small, grouped blisters (vesicles) and lots of inflammation (erythema).
HSV infection is ubiquitous, with an estimated one third of the population worldwide suffering from recurrent infections.
Patients with HSV keratitis may complain of the following: › Pain › Photophobia › Poor vision › Profuse lacrimation › Blepharospasm
Corneal stromal inflammation Infectious epithelial keratitis
Endothelitis Blepharo- conjunctivitis
Dendritic ulcer stained with fluorescin
Dendritic ulcer stained with Rose Bengal
Eye infectionThroat infectionEczema herpeticum
Erythema multiformNervous systemWidespread infection
Bacterial & fungal keratitis Peripheral ulcerative keratitis Superficial punctate keratitis
Acanthamoeba keratitis Photokeratitis Interstitial keratitis
Local Antiviral (acyclovir) Atropine Local antibiotic Bandage General Vit A & Vit C Acyclovir tablet Resistant Debridement Cauterization Therapeutic keratopathy
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