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Recurrent Herpetic Stromal Keratitis in Mice, a Model for Studying Human HSK
07:27

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Published on: December 18, 2012

Bilateral herpes simplex keratitis presenting as peripheral ulcerative keratitis.

Anna Praidou1, Sofia Androudi, Evgenia Kanonidou

  • 1Department of Ophthalmology, Aristotle University, Thessaloniki, Greece. praidou2003@yahoo.co.uk

Cornea
|March 2, 2012
PubMed
Summary

Bilateral herpetic keratitis mimicking peripheral ulcerative keratitis is rare. Prompt diagnosis and treatment of Herpes simplex virus (HSV) keratitis are crucial for vision preservation.

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Published on: September 20, 2021

Area of Science:

  • Ophthalmology
  • Infectious Diseases

Background:

  • Peripheral ulcerative keratitis (PUK) can be challenging to diagnose, especially in patients with autoimmune conditions.
  • Herpes simplex keratitis (HSK) typically presents with characteristic corneal findings, but can have atypical presentations.

Observation:

  • A 47-year-old female with a history of autoimmune disease presented with bilateral red eyes and corneal ulcers suggestive of PUK.
  • Biomicroscopy revealed peripheral corneal ulcerations, stromal infiltrates, and bilateral central epithelial erosions.
  • Anterior chamber inflammation was noted in both eyes.

Findings:

  • Polymerase chain reaction (PCR) confirmed Herpes simplex virus (HSV) antigen in both eyes.
  • Treatment with topical corticosteroids, topical and systemic antivirals led to gradual improvement.
  • Corneal epithelial defects, PUK, and visual acuity improved during follow-up.

Implications:

  • This case highlights the importance of considering HSK in the differential diagnosis of PUK, particularly in immunocompromised or systemically unwell patients.
  • Early identification and management of infectious etiologies are critical to prevent vision loss.
  • Atypical presentations of HSK underscore the need for comprehensive diagnostic workups in complex ocular inflammatory conditions.