Herpes Keratitis and Conjunctivitis
Description Diagnostic criteria General and supportive measures Medicine treatment Referral ICD-10 code: 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 wi
Description
Diagnostic criteria
General and supportive measures
Medicine treatment
Referral
ICD-10 code: 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 an 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 5 times per day for 10 days.
OR
- Aciclovir, orally, 20 mg/kg, 5 times per day for 10 days.
If painful ciliary spasm is present:
- Atropine, ophthalmic drops, instil 1 drop, 12 hourly.
REFERRAL
Urgent within 24 hours:
- If the corneal lesion is not clean/clear or has whitish areas within the bed of the epithelial ulcer.
- If the 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.
Standard Treatment Guidelines and Essential Medicines List for South Africa Paediatric Hospital _2023, 5th edition_Updated July 2024
Chapter 16: Eye Conditions, 16.3 Herpes Keratitis And Conjunctivitis