B00.5
DESCRIPTION
Herpes infection of the cornea and/or conjunctiva.
DIAGNOSTIC CRITERIA
There are three most common forms of this disease.
Blepharoconjunctivitis
- Primary ocular infection involving the eyelids, and/or conjunctivae.
- The condition is benign and self limiting.
- May be associated with keratitis: tiny punctuate stains on the cornea when stained with fluorescein and viewed with the cobalt blue light of the direct ophthalmoscope.
Disciform keratitis
- Immune response to herpes virus.
- Decreased visual acuity and corneal sensation.
- Round dull swollen area in the central cornea.
- Decreased sensation when compared to the other eye. (Use a thread of cotton from a cotton bud and touch the cornea from the side, away from the visual axis.)
- Refer to ophthalmologist.
Dendritic ulcer
- A linear branching ulcer (dendritic ulcer) when stained with fluorescein and viewed with the cobalt blue light of the direct ophthalmoscope.
- Decreased sensation when compared to the other eye. (Use a thread of cotton from a cotton bud and touch the cornea from the side, away from the visual axis).
GENERAL AND SUPPORTIVE MEASURES
- Pad the eye.
MEDICINE TREATMENT
- Aciclovir, ophthalmic ointment, applied five times per day for 10 days.
If cilliary spasm present:
- Cyclopentolate, ophthalmic drops, instil 1 drop 8 hourly.
REFERRAL
Urgent within 24 hours:
- If corneal lesion is not clean/clear or has whitish areas within the bed of the epithelial ulcer.
- If area of corneal staining is not smaller within 24 hours of treatment.
- If there is a history of recurrence.
- Disciform keratitis for assessment and treatment.