Treatment of herpetic keratitis with acyclovir: benefits and problems

Since the introduction of acyclovir in the last decade, the visual prognosis of herpetic keratitis has improved dramatically. Benefits with this superb agent include rapid resolution of epithelial keratitis, reduction of disturbances in ocular surface epithelia, and a decreased incidence of necrotizing keratitis or subsequent corneal melting. On the other hand, persistent superficial punctate keratopathy associated with topical usage, emergence of an acyclovir-resistant strain of herpes simplex virus, and a gradual increase in progressive corneal endotheliitis comprise the problems to be resolved.