Herpes virus causes:
Ans: a (Dendritic ulcer) Ref. AK Khurana, 4th ed, p. 102Dendritic ulcer is a typical lesion of recurrent epithelial keratitis. It is an irregular linear branching ulcer with knobbed ends. There will be decreased corneal sensation.On staining the floor of the ulcer takes flourescien dye whereas virus laden cells at the margin take rose Bengal.Ocular lesions of herpes simplexA. Primary ocular herpesB. Recurrent herpes.Usually attacks nonimmune children & teenagers.Self limiting but establishes latent infection in trigeminal ganglion.1. skin lesions- vesicles2. acute follicular conjunctivitis3. corneal lesions- fine epithelial punctate keratitis coarse epithelial punctuate keratitsa. Active epithelial keratitis- Punctate epithelial keratiti;-dendritic ulcer-geographic ulcer(amoeboid ulcer)b. Stromal keratitis-disciform keratitis diffuse stromal necrotic keratitisc. Trophic keratitis (metaherpetic keratitis)d. Herpetic iridocyclitisOther important points1. Antiviral dings are the first choice dings2. In general steroids are contraindicated in herpes simplex keratitis but steroids are indicated in the treatment of stromal keratitis only.3. Steroid resistant cases of diffuse stromal keratitis -Rx is keratoplasty4. Metaherpetic keratitis is not an active viral disease but mechanical healing problem5. Rx of metaherpetic keratitis -soft contact lens & artificial tearsPoints about Herpes Zoster Ophthalmicus* Acute infection of gasserian ganglion* VZ virus is a DNA virus with acidophilic intranuclear inclusion bodies* Frontal nerve is more frequently involved than lacrimal & nasociliary nerve* Hutchison's rule- cutaneous involvement of nasociliary nerve with vesicles on the side or tip of nose implies that ocular involvement is frequent.* Corneal lesions are:Micronodular epithelial ulcerNummular keratitisDisciform keratitisNeuroparalityic keratitisExposure keratitis
Dendritic ulcer
Serpenginous ulcer
Hypopyon corneal ulcer
Ccorneal erosion
Cornea