 It is a primary, superficial, infective ulcer having a dendritic shape caused by Herpes Simplex Virus (epitheliotropic type).

Dendritic ulcer stained with fluorescin

Herpes Simplex virus

Primarily responsible, above waist Orofacial & ocular infection HSV-1 Transmitted sexually Genital diseases, passed to neonates HSV-2

Virus becomes dormant in trigeminal (V) ganglion Inter-neuronal spread 1ry HSV-1 infection; in childhood Direct contact of skin or mucous membrane with virus-laden lesions or secretions

Fever Menstruation Drugs Psychic stress Low resistance

Recurrence occurs with decreased body resistance Virus becomes active Vesicles in mouth, genitalia, cornea

 Close-up view of early herpes outbreak shows small, grouped blisters (vesicles) and lots of inflammation (erythema).

 HSV infection is ubiquitous, with an estimated one third of the population worldwide suffering from recurrent infections.

 Patients with HSV keratitis may complain of the following: › Pain › Photophobia › Poor vision › Profuse lacrimation › Blepharospasm

 Corneal stromal inflammation  Infectious epithelial keratitis

 Endothelitis  Blepharo- conjunctivitis

 Dendritic ulcer stained with fluorescin

 Dendritic ulcer stained with Rose Bengal

Eye infectionThroat infectionEczema herpeticum

Erythema multiformNervous systemWidespread infection

Bacterial & fungal keratitis Peripheral ulcerative keratitis Superficial punctate keratitis

Acanthamoeba keratitis Photokeratitis Interstitial keratitis

Local Antiviral (acyclovir) Atropine Local antibiotic Bandage General Vit A & Vit C Acyclovir tablet Resistant Debridement Cauterization Therapeutic keratopathy