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Chapter 12 – Herpetic keratitis

Pranita P Sarangi,
Barry T Rouse

Clinical background

Herpetic keratitis usually results from infection with herpes simplex virus type 1 (HSV-1) in adults and by HSV-2 in neonates. Occasionally the cause is varicella-zoster virus (VZV), either during primary infection or more commonly, as a site during an outbreak of shingles. The epidemiology of HSV-1 and HSV-2 infection is being changed as a consequence of different patterns of human sexual behavior. Persons are seroconverting to HSV-1 later in life and many are now first exposed to the virus as a genital infection.[1] HSV-2 infection is on the increase and more frequently than before may be the cause of keratitis.

Primary infection, especially with HSV-1, may be subclinical or mild and misdiagnosed. However, it can cause a painful lesion that mainly affects the corneal epithelium, lasting for several days or even weeks, but which eventually resolves without permanent damage to the cornea. This event occurs more …