Related Experiment Video
Updated: Feb 10, 2026

07:27
Recurrent Herpetic Stromal Keratitis in Mice, a Model for Studying Human HSK
Published on: December 18, 2012
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Stromal Keratitis in the Zoster Eye Disease Study: Lessons Learned
Deborah S Jacobs1, TingFang Lee2, Penny Asbell3
1From the Harvard Medical School, Boston, Massachusetts, USA (D.S.J.).
American Journal of Ophthalmology
|February 8, 2026
Summary
Stromal keratitis (SK) in Herpes Zoster Ophthalmicus (HZO) patients often resolves with close monitoring and treatment, maintaining good vision without oral antivirals. Low-potency topical steroids are recommended for managing SK in HZO.
Area of Science:
- Ophthalmology
- Virology
- Infectious Diseases
Background:
- Herpes Zoster Ophthalmicus (HZO) can lead to ocular complications, including stromal keratitis (SK).
- The Zoster Eye Disease Study (ZEDS) investigated the efficacy of oral valacyclovir in HZO patients.
Purpose of the Study:
- To analyze the presentation, treatment, and visual outcomes of stromal keratitis (SK) within the Zoster Eye Disease Study (ZEDS).
Main Methods:
- Secondary analysis of SK as an endpoint in a randomized clinical trial of oral valacyclovir versus placebo in HZO patients.
- Prospective follow-up for 18 months, with retrospective evaluation of SK presentation, treatment with topical steroids, and visual acuity at 12 months.
Main Results:
- Stromal keratitis (SK) occurred in 20% of participants, unrelated to valacyclovir treatment.
- Visual acuity remained stable, with no significant difference between treatment groups.
- Most SK cases were detected at scheduled visits; oral antiviral treatment was infrequent. Topical steroid use varied, with many patients receiving low-potency steroids or dose adjustments.
Conclusions:
- Patients with HZO-related SK generally maintain good vision with monitoring and prompt treatment, often without oral antivirals.
- Low-potency topical steroids are suggested for managing and suppressing SK in HZO patients.
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