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Update on management of herpes keratitis in children

Karen Revere1, Stefanie L Davidson

  • 1Scheie Eye Institute, University of Pennsylvania, Philadelphia, PA, USA.

Current Opinion in Ophthalmology
|May 14, 2013
PubMed

Insights

Herpetic keratitis recurs more often in children, potentially causing vision loss due to corneal scarring. Prompt diagnosis and oral acyclovir treatment are crucial for managing this pediatric eye condition.

Area of Science:

  • Ophthalmology
  • Infectious Diseases
  • Pediatrics

Background:

  • Herpetic keratitis, an infection of the cornea caused by herpes simplex virus, presents unique challenges in pediatric patients.
  • Amblyopia and vision loss are significant risks in children due to corneal scarring from recurrent herpetic keratitis.

Purpose of the Study:

  • To review clinical presentations, diagnostic methods, and treatment strategies for herpetic keratitis in 2012.
  • To specifically address the nuances of herpetic keratitis in the pediatric population.

Main Methods:

  • Literature review of articles published in 2012 focusing on herpetic keratitis.
  • Analysis of studies concerning diagnosis, treatment, and outcomes, with emphasis on pediatric cases.

Main Results:

  • Herpetic keratitis shows a higher recurrence rate in children than adults, often manifesting as stromal disease.
  • Oral acyclovir is a safe and effective treatment for pediatric herpetic keratitis, preferred over topical antiviral eye drops.
  • Immunochromatographic assay offers high specificity for diagnosing herpes simplex virus-1 (HSV) in corneal scrapings, while real-time PCR can monitor viral load and detect resistance.

Conclusions:

  • Delayed diagnosis and antiviral resistance contribute to severe corneal opacification, particularly detrimental in children at risk for amblyopia.
  • The unique presentation of herpetic keratitis in children complicates rapid diagnosis and treatment, underscoring the need for specialized approaches.
  • Effective management requires timely diagnosis and appropriate antiviral therapy to prevent irreversible vision loss in pediatric patients.
Abstract

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