Ophthalmology Book


Herpes Simplex Keratitis

Aka: Herpes Simplex Keratitis, Herpes Keratitis, Herpetic Keratitis, Herpes Simplex Conjunctivitis, HSV Conjunctivitis, Herpetic Dendrite, Dendritic Keratitis, Dendritic Ulcer
  1. Epidemiology
    1. Outbreaks in winter and early summer
  2. Symptoms
    1. Previous history of Herpes Keratitis
    2. Coexisting Fever Blister (herpetic rash) on lip or upper face
    3. Recent Upper Respiratory Infection
    4. Absent history of Corneal Trauma
    5. Severe Eye Pain
    6. Photophobia
    7. Eye Discharge
    8. Gritty Sensation in eye
  3. Signs
    1. Unilateral inflammation of Conjunctiva and Cornea
    2. Dendritic Ulcers on Fluorescein staining of Cornea (consider rose bengal strips if available)
    3. Reduced Corneal sensitivity
    4. Preauricualar node (anterior to tragus)
  4. Complications
    1. Corneal Ulcer and scarring with obscured Vision
  5. Management
    1. Urgent Ophthalmology referral
    2. Consider Hospital admission
    3. AVOID Topical Steroids
    4. Topical antivirals
      1. Ganciclovir 0.15% ophthalmic gel (Zirgan)
      2. Trifluridine 1% drops (Viroptic)
    5. Systemic Acyclovir or other antiviral agents
      1. Do not use topical Acyclovir due to to Corneal toxicity
  6. References
    1. Williams (2017) Crit Dec Emerg Med 31(2): 3-12
    2. Pflipsen (2016) Am Fam Physician 93(12): 991-8 [PubMed]

Keratitis, Herpetic (C0019357)

Definition (MSHFRE) Infection de l'épithélium de la cornée due au virus herpès hominis. Elle est caractérisée par de petites vésicules qui peuvent éclater et fusionner pour former un ulcère dendritique. (Dictionary of Visual Science, 3d ed)
Definition (MSHCZE) Keratitis dendritica – lat. povrchový zánět rohovky (keratitida) vznikající při infekci virem herpes simplex (herpes corneae). Defekty rohovkového epitelu vytvářejí větvičkové struktury (srov. keratitis punctata superficialis). Typická pro virové postižení rohovky je její hypestezie až anestezie. (cit. Velký lékařský slovník online, 2013 http://lekarske.slovniky.cz/ )
Definition (CSP) herpes of the eye and its adnexa.
Definition (MSH) A superficial, epithelial Herpesvirus hominis infection of the cornea, characterized by the presence of small vesicles which may break down and coalesce to form dendritic ulcers (KERATITIS, DENDRITIC). (Dictionary of Visual Science, 3d ed)
Concepts Disease or Syndrome (T047)
MSH D016849
SnomedCT 186546003, 154335009, 186547007, 283161000009101, 186542001, 9389005
English Herpes Simplex Keratitides, Herpes Simplex Keratitis, Herpes Simplex, Ocular, Herpetic Keratitides, Herpetic Keratitis, Keratitides, Herpes Simplex, Keratitides, Herpetic, Keratitis, Herpes Simplex, Keratitis, Herpetic, Ocular Herpes Simplex, HERPES OCULAR, Ophthalmic herpes simplex NOS, HERPES SIMPLEX KERATITIS, Herpes simplex keratitis (diagnosis), Herpes ocular, Herpes ophthalmic NOS, Keratitis, Herpetic [Disease/Finding], herpes keratitis, eyes herpes, herpes ocular, herpes ophthalmic, ocular simplex herpes, eye herpes, Herpes;eye, Herpes simplex;ophthalmic, hsv keratitis, herpes eye, herpetic keratitis, ocular herpes, ophthalmic herpes, herpes simplex keratitis, corneal herpes, ocular herpes simplex, Ophthalmic herpes simplex NOS (disorder), Corneal herpes, Keratitis herpetic, Herpes simplex ophthalmic, Keratitis due to Herpesvirus, Herpesvirus keratitis, Keratitis due to Herpesvirus (disorder), Herpes simplex ophthalmicus, Herpes ophthalmic, Herpes simplex keratitis, Ophthalmic herpes simplex, Herpetic keratitis, HSV keratitis, Herpes simplex keratitis (disorder), Ophthalmic herpes simplex (disorder), herpes of the eye, ophthalmic herpes simplex
Italian Herpes oftalmico, Herpes oftalmico NAS, Herpes oculare, Herpes simplex oculare, Cheratite da herpes simplex, Herpes simplex oftalmico, Herpes della cornea, Cheratite erpetica
Dutch herpes oftalmisch NAO, herpes oculair, oftalmische herpes simplex, herpetische keratitis, keratitis herpetisch, herpes-simplex-keratitis, herpes simplex oftalmisch, hoornvliesherpes, herpes oftalmisch, Herpes simplex, oculaire, Herpes-simplexkeratitis, Keratitis herpetica
French Herpès ophtalmique SAI, HERPES OCULAIRE, Herpès cornéen, Herpes simplex oculaire, Herpès simplex ophtalmique, Kératite due à Herpes simplex, Herpès ophtalmique, Herpès simplex oculaire, Kératite herpétique, Herpès oculaire
German Herpes, okulaer, Herpes des Auges NNB, HERPES AUGE, Hornhautinfektion durch Herpes, Herpes simplex des Auges, Keratitis durch Herpes, Keratitis durch Herpes simplex, Herpes simplex am Auge, herpetische Keratitis, Herpes des Auges, Herpes corneae, Herpes-simplex-Keratitis, Keratitis, Herpes-, Herpes simplex, okulärer
Portuguese Herpes oftálmico NE, Herpes ocular, HERPES OCULAR, Herpes da córnea, Queratite de herpes simples, Queratite herpética, Herpes simples oftálmico, Herpes oftálmico, Ceratite Herpética, Ceratite por Herpes Simples, Herpes Simples Ocular
Spanish Herpes ocular, Herpes oftálmico NEOM, HERPES OCULAR, Herpes simplex oftálmico, SAI (trastorno), Herpes simplex oftálmico, SAI, Queratitis herpética, Herpes corneal, Queratitis por herpes simplex, Herpes simplex oftálmico, herpes simple oftálmico (trastorno), herpes simple oftálmico, queratitis herpética, queratitis por virus del herpes simple (trastorno), queratitis por virus del herpes simplex, queratitis por virus del herpes simple, Herpes oftálmico, queratitis por Herpes simplex, Herpes Simple Ocular, Queratitis Herpética, Queratitis por Herpes Simple
Japanese ヘルペス眼感染NOS, ヘルペス眼感染, 眼ヘルペス, ヘルペスガンカンセンNOS, ガンヘルペス, ヘルペスガンカンセン, 単純ヘルペス-眼部, 角膜炎-単純ヘルペス, ガンブタンジュンヘルペス, カクマクヘルペス, 単純ヘルペス性角膜炎, タンジュンヘルペスセイカクマクエン, ヘルペスセイカクマクエン, ヘルペス性角膜炎, 単純ヘルペス角膜炎, 疱疹性角膜炎, 眼部単純ヘルペス, 角膜ヘルペス, 角膜疱疹, 角膜炎-ヘルペス性, 角膜炎-疱疹性
Swedish Herpeskeratit
Czech keratitida herpetická, Oční herpetická infekce, Herpes ophthalmicus, Oční herpetická infekce NOS, Herpes simplex oka, Herpes rohovky, Oční Herpes simplex, Keratitida způsobená herpes simplex virem, Herpetická keratitida
Finnish Herpeskeratiitti
Croatian Not Translated[Keratitis, Herpetic]
Polish Opryszczka zwykła oka, Zapalenie rogówki opryszczkowe
Hungarian Herpes ocularis, Herpes ophthalmicus, herpes ophthalmicus k.m.n., herpes simplex ophthalmicus, keratitis herpetica, Herpes simplex keratitis, herpeses keratitis, Herpes simplex ophthalmicus, Cornealis herpes
Norwegian Herpes simplex-keratitt, Okulær herpes simplex, Keratitt, herpetisk, Herpeskeratitt, Herpetisk keratitt
Derived from the NIH UMLS (Unified Medical Language System)

Keratitis, Dendritic (C0022570)

Definition (MSHCZE) Keratitis dendritica – lat. povrchový zánět rohovky (keratitida) vznikající při infekci virem herpes simplex (herpes corneae). Defekty rohovkového epitelu vytvářejí větvičkové struktury (srov. keratitis punctata superficialis). Typická pro virové postižení rohovky je její hypestezie až anestezie. (cit. Velký lékařský slovník online, 2013 http://lekarske.slovniky.cz/ )
Definition (MSH) A form of herpetic keratitis characterized by the formation of small vesicles which break down and coalesce to form recurring dendritic ulcers, characteristically irregular, linear, branching, and ending in knoblike extremities. (Dictionary of Visual Science, 3d ed)
Concepts Disease or Syndrome (T047)
MSH D007635
ICD9 054.42
SnomedCT 29943008
English Dendritic Keratitides, Furrow Keratitides, Furrow Keratitis, Keratitides, Dendritic, Keratitides, Furrow, Keratitis, Dendritic, Keratitis, Furrow, Herpes simp.dendritic keratit., keratitis dentritic, dendritic keratitis (diagnosis), dendritic keratitis, epithelial dendritic keratitis was observed, dendritic Herpes simplex keratitis, dendritic Herpes simplex keratitis (diagnosis), dendritic keratitis (physical finding), Keratitis, Dendritic [Disease/Finding], Dendritic keratitis, Herpes simplex dendritic keratitis, HSV dendritic keratitis, Herpes simplex dendritic keratitis (disorder), Dendritic Keratitis
Swedish Keratit, dendritisk
Czech keratitida dendritická, Keratitis dendritica, keratitis dendritica
Finnish Dendriittinen keratiitti
Polish Zapalenie rogówki herpetyczne, Opryszczka rogówki, Zapalenie rogówki drzewiaste
Japanese 角膜炎-溝状, 角膜炎-樹枝状, ジュシジョウカクマクエン, 樹枝状角膜潰瘍, 樹枝状角膜炎, 溝状角膜炎
Norwegian Keratitt, dendrittisk, Dendrittisk keratitt, Keratitis dendritica
Dutch dendritische keratitis, Furrow-keratitis, Keratitis dendritica, Keratitis, Furrow-
German dendritische Keratitis, Furchenkeratitis, Keratitis dendritica, Keratitis, Furchen-
Hungarian Dendriticus keratitis
Portuguese Queratite dendrítica, Ceratite de Furrow, Ceratite Dendrítica
Spanish Queratitis dendrítica, queratitis dendrítica herpética, queratitis dendrítica por virus del herpes simple (trastorno), queratitis dendrítica por virus del herpes simplex, queratitis dendrítica por virus del herpes simple, queratitis dendrítica por Herpes simplex, Queratitis de Furrow, Queratitis Dendrítica
French Kératite dendritique
Italian Cheratite dendritica
Derived from the NIH UMLS (Unified Medical Language System)

Dendritic ulcer (C0333303)

Concepts Acquired Abnormality (T020)
SnomedCT 63280002, 246935009, 155153004, 193764001
English Dendritic ulceration, Herpetic ulceration of cornea, Dendritic ulcer (M-38190), dendritic ulcer, Ulcer;dendritic, dendritic ulcers, Dendritic ulceration (disorder), Dendritic ulcer, Dendritic ulcer (disorder), Dendritic ulcer (morphologic abnormality)
Czech Dendritický vřed rohovky
Dutch dendritische zweer
French Ulcère dendritique
German dendritisches Ulkus
Hungarian Dendriticus fekély
Italian Ulcera dendritica
Japanese ジュシジョウカイヨウ, 樹枝状潰瘍
Portuguese Úlcera dendrítica
Spanish Úlcera dendrítica, úlcera dendrítica (anomalía morfológica), úlcera dendrítica (trastorno), úlcera dendrítica
Derived from the NIH UMLS (Unified Medical Language System)

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