Herpetic keratitis after corneal crosslinking.

Area of Science:

• Ophthalmology
• Infectious Diseases
• Corneal Surgery

Background:

• Corneal crosslinking (CXL) is a standard treatment for progressive keratoconus.
• While generally safe, rare sight-threatening complications can occur post-CXL.

Observation:

• A 40-year-old woman developed severe pain and photophobia after CXL for keratoconus.
• Clinical examination revealed corneal stromal infiltrates and epithelial defects.
• Polymerase chain reaction confirmed Herpes Simplex Virus type 1 (HSV-1) as the cause.

Findings:

• The patient was diagnosed with new-onset herpetic keratitis (HK) post-corneal crosslinking.
• Treatment with oral valacyclovir, topical corticosteroids, and lubricants led to healing of the epithelial defect and reduced stromal infiltrate.

Implications:

• This case highlights the potential risk of developing herpetic keratitis following corneal crosslinking.
• Ophthalmologists must consider HK in the differential diagnosis of post-CXL complications, even without a prior history of HSV infection.
• Prompt diagnosis and management are essential for favorable outcomes in post-CXL herpetic keratitis.