The clinical and statistical review were carried out with 92 cases of herpetic keratitis at the Dept. of Ophthalmology, St. Mary's Hospital, Catholic Medical College from Jan. 1974 to Aug. 1976. The results were as follow: 1. Herpetic keratitis was most prevalent at the age of 30's and least at those under 10 and 60'. 2. Male and female ratio was about 3 : 1 but the ratio under the age of 20 was even. 3. The most epidemic season was from March to June, amounting to about 56.5% of the total, and exhaustion was the most significant predisposing factor. 4. The simple type of herpetic keratitis was 45 cases (48.9%) of the total while the complicated type was 47 cases(51.1%). Four fifth of simple type was dendritic keratitis with 36cases (39.1%) and disciform keratitis was most frequent among the complicated type with 20 cases (21.7%). 5. Involvement was even between left and right eyes. 80% of binocular cases was primarily involved at the age of over 20's. Among binocular cases, both eyes showed similar signs and course. 6. Vision in the early stage depends on the location of keratitis invloved. Twenty two out of twenty three cases with duration over 3 years displayed and obvious decreased vision less than 0.1 which implied that the longer the duration is, the more evident the disturbance in vIsion is. 7. In 30 cases the effect of 5-ido-2'-deoxyuridine (I.D.U.) was excellent while there was no effective response to the 5-iodo-2'-deoxyuridine (I.D.U.) in 29 cases. In cases resistant against I.D.U., cryotherapy and keratoplasty proved to be very effective.
Causality ; Corneal Transplantation ; Cryotherapy ; Female ; Humans ; Idoxuridine ; Keratitis* ; Keratitis, Dendritic ; Keratitis, Herpetic ; Male ; Ophthalmology ; Seasons ; Telescopes

Herpes simplex virus keratits(HSK) is one of the most common external eye diseases that cause corneal blindness, Therefore early diagnosis and proper treatment of HSK are essential. However it is frequently misdiagnosed because it shows non-specific corneal lesion than other infectious corneal disease. And also diagnosis of HSK mostly rely on clinical examination and patient history. We evaluated suspicious HSK patients by indirect immunofluofluorescent(IF) antibody test and analyzed its efficacy in the early diagnosis of HSK. Among 47 patients(47 eyes), 37 patients were suspicious heretic keratitis and others not. Dendritic keratitis patients existed in 17 out of 37 patients and they were evaluated with virus culture and indirect IF test. The result of indirect IF test was confirmed under the immunofluorescent microscope and for virus culture the specimens were inoculated on Vero cells(monkey kidney cells). The positive results of indirect IF test was 28 out of 37 suspicious HSK patients and 1 out of 10 non-suspicious HSK patients. Dendritic HSK patients showed IF positive in 15 out of 17 patients(82.3%). Sensitivity of indirect IF test in suspicious HSK patients was 75.7%(2837) and 88.2%(15/17) in dendritic HSK patients. Indirect IF test was all positive(14/14) in dendritic HSK patients that showed culture positive. From these results, indirect IF test has a high sensitivity in early diagnosis of HSK and might be ussful as a rapid diagnostic tool in HSK patients.
Blindness ; Corneal Diseases ; Diagnosis ; Early Diagnosis ; Eye Diseases ; Herpes Simplex* ; Humans ; Keratitis ; Keratitis, Dendritic ; Keratitis, Herpetic* ; Kidney ; Simplexvirus

Herpes simplex virus keratits(HSK) is one of the most common external eye diseases that cause corneal blindness, Therefore early diagnosis and proper treatment of HSK are essential. However it is frequently misdiagnosed because it shows non-specific corneal lesion than other infectious corneal disease. And also diagnosis of HSK mostly rely on clinical examination and patient history. We evaluated suspicious HSK patients by indirect immunofluofluorescent(IF) antibody test and analyzed its efficacy in the early diagnosis of HSK. Among 47 patients(47 eyes), 37 patients were suspicious heretic keratitis and others not. Dendritic keratitis patients existed in 17 out of 37 patients and they were evaluated with virus culture and indirect IF test. The result of indirect IF test was confirmed under the immunofluorescent microscope and for virus culture the specimens were inoculated on Vero cells(monkey kidney cells). The positive results of indirect IF test was 28 out of 37 suspicious HSK patients and 1 out of 10 non-suspicious HSK patients. Dendritic HSK patients showed IF positive in 15 out of 17 patients(82.3%). Sensitivity of indirect IF test in suspicious HSK patients was 75.7%(2837) and 88.2%(15/17) in dendritic HSK patients. Indirect IF test was all positive(14/14) in dendritic HSK patients that showed culture positive. From these results, indirect IF test has a high sensitivity in early diagnosis of HSK and might be ussful as a rapid diagnostic tool in HSK patients.
Blindness ; Corneal Diseases ; Diagnosis ; Early Diagnosis ; Eye Diseases ; Herpes Simplex* ; Humans ; Keratitis ; Keratitis, Dendritic ; Keratitis, Herpetic* ; Kidney ; Simplexvirus

PURPOSE: We report the therapeutic effect of ganciclovir gel instead of acyclovir ointment usually used in the case of herpes simplex superficial ocular disease such as herpetic dendritic keratitis and erosive blepharitis. METHODS: Three patients clinically diagnosed with herpes simplex dendritic keratitis and one as erosive blepharitis were treated with the topical ophthalmic gel of 0.15% ganciclovir three times a day for 2 to 4 weeks. Ocular complications and recurrence were evaluated under slit-lamp examination for the follow-up periods. RESULTS: Dendritic keratitis and erosive blepharitis were completely recovered with no recurrence during the 5 months follow-up. There is no respective comparison here. In one case of herpes simplex keratitis, the keratitis wound was repaired after debridement of corneal epithelial layer and application of ganciclovir gel. Complications including burning sensation and superficial punctate keratitis did not develop and visual acuity improved. CONCLUSIONS: Ganciclovir ophthalmic gel should be considered one of the effective therapeutic drugs for the herpes simplex ocular disease.
Acyclovir ; Blepharitis ; Burns ; Debridement ; Follow-Up Studies ; Ganciclovir* ; Herpes Simplex* ; Humans ; Keratitis ; Keratitis, Dendritic ; Keratitis, Herpetic ; Recurrence ; Sensation ; Visual Acuity ; Wounds and Injuries

PURPOSE: We report an unusual case of presumptive diagnosis of herpes-induced anterior uveitis with acute hypopyon after trauma. CASE SUMMARY: A 82-year-old male was diagnosed with herpes keratitis due to dendritic keratitis in the left eye, and the lesion disappeared after antiviral treatment. However, 1 year later, the patient visited again with visual loss, pain, and tearing of the left eye after trauma. At the examination, best-corrected visual acuity was counting fingers and the intraocular pressure was 27 mmHg in the left eye. Slit-lamp examination revealed corneal epithelial erosion, moderate corneal edema, and prominent inflammation with 2 mm high hypopyon in the anterior chamber. We thought that bacterial endophthalmitis had rapidly progressed after trauma, so we performed bacterial cultures and an intravitreal antibiotics injection. Considering the clinical manifestations of lesions and herpes keratitis in the past, we could not exclude herpes virus infection. Cultures were negative and the symptoms improved, so the antiviral treatment was gradually reduced and stopped at 2 months. However, recurrence was observed on day 5 after stopping antiviral therapy. We therefore assumed that recurrent herpes virus caused anterior uveitis, and then, antiviral and steroid therapy was resumed. The patient subsequently showed improvement in his symptoms and recovered his visual acuity. CONCLUSIONS: When acute hypopyon is observed in the anterior chamber after trauma, not only bacterial iritis and endophthalmitis but also viral-induced anterior uveitis should be considered in the differential diagnosis.
Aged, 80 and over ; Anterior Chamber ; Anti-Bacterial Agents ; Corneal Edema ; Diagnosis ; Diagnosis, Differential ; Endophthalmitis ; Fingers ; Humans ; Inflammation ; Intraocular Pressure ; Iritis ; Keratitis ; Keratitis, Dendritic ; Male ; Recurrence ; Simplexvirus ; Tears ; Uveitis, Anterior ; Visual Acuity

No abstract available.
Adult ; Aged ; Child ; Female ; Herpes Genitalis/diagnosis* ; Human ; Infant, Newborn ; Keratitis, Dendritic/diagnosis* ; Male ; Middle Age ; Risk ; Support, U.S. Gov't, P.H.S.