OVERVIEW

INTRODUCTION

While comprehensive ophthalmologists and optometrists may only see a few cases of herpetic keratitis each year, the condition remains a common cause of ocular morbidity and has the potential to significantly compromise vision.1 Prompt, accurate diagnosis and appropriate treatment are essential to achieving favorable outcomes, and surveys suggest that clinicians may take a variety of approaches to managing herpetic keratitis.1,2

With a goal of clarifying the current understanding of and standards for managing epithelial herpetic keratitis, this collection of articles, commentary, images, and video has been developed in concert with leading ophthalmologists specializing in corneal and infectious diseases. At the heart of this collection is a practical algorithm for the diagnosis and pharmaceutical management of epithelial herpetic keratitis. Readers are encouraged to explore and share the algorithm, supporting literature, and illustrative content with colleagues.

REFERENCES

  1. Guess S, Stone DU, Chodosh J. Evidence-based treatment of herpes simplex virus keratitis: a systematic review. Ocul Surf. 2007;5:240-50.
  2. Wilhelmus KR. Antiviral treatment and other therapeutic interventions for herpes simplex virus epithelial keratitis. Cochrane Database of Systematic Reviews 2010, Issue 12.

ABOUT HSK

Ocular infection with herpes simplex virus (HSV) affects approximately 400,000 individuals in the US and is a leading infectious cause of corneal blindness in the developed world.1 Of the various presentations of HSV eye disease, herpetic keratitis (HK) is the most common and, in its most severe form, is a major indication for corneal transplantation.1 Approximately 20,000 new cases and 48,000 recurrences of HK are diagnosed each year in the US, although other estimates suggest a higher incidence.2,3

REFERENCES

  1. Toma HS, Murina AT, Areaux RG Jr, et al. Ocular HSV-1 latency, reactivation and recurrent disease. Semin Ophthalmol. 2008;23:249-273.
  2. Liesegang TJ. Herpes simplex virus epidemiology and ocular importance. Cornea. 2001;20:1-13.
  3. Young RC, Hodge DO, Liesegang TJ, Baratz KH. Incidence, recurrence, and outcomes of herpes simplex virus eye disease in Olmsted County, Minnesota, 1976-2007: the effect of oral antiviral prophylaxis. Arch Ophthalmol. 2010;128:1178-1183.

COMMITTEE MEMBERS

Marguerite B. McDonald, MD, Chair,

Marguerite B. McDonald, MD, Chair,

is a cornea specialist with Ophthalmic Consultants of Long Island, Lynbrook, NY. She is a clinical professor of ophthalmology at the New York University Langone Medical Center, New York, NY, and an adjunct clinical professor of ophthalmology at the Tulane University Health Sciences Center, New Orleans, LA.
David R. Hardten, MD,

David R. Hardten, MD,

is a founding partner and director of clinical research at Minnesota Eye Consultants, Minneapolis, MN. He is an adjunct associate professor of ophthalmology at the University of Minnesota Medical School, and an adjunct professor at the Illinois College of Optometry, Chicago, IL.
Francis S. Mah, MD,

Francis S. Mah, MD,

is director of the cornea and external disease service and co-director of the refractive surgery service at the Scripps Clinic, La Jolla, CA. He is a consultant to the Charles T. Campbell Eye Microbiology Laboratory of the University of Pittsburgh Medical Center.
Terrence P. O'Brien, MD,

Terrence P. O'Brien, MD,

is Charlotte Breyer Rodgers Distinguished Chair in Ophthalmology and codirector of ocular microbiology at Bascom Palmer Eye Institute of the University of Miami School of Medicine, Palm Beach, FL.
Christopher J. Rapuano, MD,

Christopher J. Rapuano, MD,

is director of the cornea service and co-director of refractive surgery at the Wills Eye Institute, Philadelphia, PA, and a professor of ophthalmology at Jefferson Medical College of Thomas Jefferson University, Philadelphia, PA.
David J. Schanzlin, MD,

David J. Schanzlin, MD,

is a cornea specialist and refractive surgeon at the Gordon Weiss Schanzlin Vision Institute, San Diego, CA. He was a professor of ophthalmology and director of keratorefractive surgery at the Shiley Eye Center, University of California, San Diego.
Neda Shamie, MD,

Neda Shamie, MD,

is an associate professor of ophthalmology and medical director of Doheny Eye Institute, Beverly Hills, CA.
John D. Sheppard MD, MMSc,

John D. Sheppard MD, MMSc,

is a president of Virginia Eye Consultants, Norfolk, VA, and a professor of ophthalmology at Eastern Virginia Medical School.
Shachar Tauber, MD,

Shachar Tauber, MD,

is a corneal and refractive surgeon and director of ophthalmic research at Mercy Medical Center, Springfield, MO.
George O. Waring IV, MD,

George O. Waring IV, MD,

is an assistant professor of ophthalmology and director of refractive surgery at the Medical University of South Carolina Storm Eye Institute and medical director of the Magill Vision Center, Charleston, SC.
 

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