Case Series: Pediatric Herpes Simplex Keratitis

Area of Science:

• Ophthalmology
• Pediatric Infectious Diseases
• Virology

Background:

• Pediatric ocular herpes simplex virus (HSV) keratitis shares clinical similarities with adult presentations.
• However, pediatric patients exhibit a higher incidence of stromal disease and recurrent infections.
• Misdiagnosis is frequent, potentially leading to severe complications like corneal scarring and amblyopia.

Observation:

• This case series details three pediatric patients diagnosed with HSV keratitis.
• Presentations varied, including prolonged unilateral disease, bilateral involvement, and initially unrecognized symptoms.
• Treatment involved oral acyclovir and topical steroids, with one patient also receiving topical antivirals.

Findings:

• All three pediatric patients with HSV keratitis achieved successful treatment outcomes.
• Therapeutic regimens included oral acyclovir and topical corticosteroids, with individualized adjustments.
• Treatment duration for pediatric ocular HSV can extend up to 12 months or longer.

Implications:

• HSV keratitis must be a key consideration in the differential diagnosis of pediatric keratitis.
• Prompt and accurate diagnosis is vital to mitigate the risk of amblyopia development.
• Effective management of pediatric ocular HSV is achievable with appropriate topical and/or oral pharmacotherapy.