[Metaherpetic keratitis clinical and virological findings (author's transl)]

2,277 specimens from 901 eyes were cultured for herpes simplex virus (HSV). 161 of 391 herpes-diseased eyes yielded HSV. The clinico-virological correlation led to a simple diagnostic and therapeutic scheme which is applicable by the ophthalmologist in his office without virological confirmation: 1. Superficial viral herpes (dendritic keratitis and allied disorders), HSV-isolating rate 96%. 2. Stromal herpes (disciform edema, different types of interstitial herpetic keratitis), only sporadical findings of HSV in the lacrimal fluid. The rate of virus-recovery increases, however, when an interstitial herpetic keratitis ulcerates. 3. Metaherpetic corneal disease = chronic or chronic recurrent superficial postherpetic disease without any detectable HSV-activity (main types: metaherpetic erosion, metaherpetic ulcer, metaherpetic bullous keratopathy). One of four superficial herpetic corneal diseases proved to be nonviral, i.e. metaherpetic in our series. Metaherpetic diseases may be widely considered as a therapeutic entity. The differential diagnosis with the slitlamp only and the proposed therapy (highly hydrophilic soft lenses plus adequate additional eye drops) are discussed in detail. Being aware of the diagnostic criteria and taking advantage of a combined soft lens therapy the treatment of metaherpetic corneal disease is easier and more successful than commonly accepted.