Herpes simplex keratitis - generalities and new perspectives.

Authors

Camelia Constantin, Mihaela Elena Cernat

Published in

Romanian journal of ophthalmology. Volume 70. Issue 3. Pages 346-349.

Abstract

Herpes simplex virus (HSV) keratitis is a prevalent and potentially blinding condition driven by recurrent corneal infections. Globally, the disease affects approximately 1.5 million individuals annually, with 40,000 new cases progressing to severe visual impairment. The distinct clinical manifestations of HSV keratitis require a comprehensive, layer-by-layer assessment of the cornea, encompassing the epithelium, stroma, and endothelium. Characteristically, active epithelial keratitis presents with classic dendritic lesions featuring terminal bulbs that stain vividly with fluorescein and rose Bengal. While typical presentations are readily identified, atypical cases necessitate advanced laboratory confirmation. Traditional diagnostic techniques include viral tissue cultures, enzyme-linked immunosorbent assays (ELISA), and cytological evaluation of Giemsa-stained corneal scrapings to detect pathognomonic multinucleated giant cells and intranuclear inclusions. Furthermore, modern modalities such as in vivo confocal microscopy (IVCM) and immunochromatographic assays (ICGA) are rapidly transitioning from research tools into promising point-of-care clinical adjuncts to enhance diagnostic precision. Prompt and targeted therapeutic management is essential to avert permanent vision loss. Treatment strategies are strictly tailored to the affected corneal layer, utilizing specific combinations of topical or oral antivirals and corticosteroids. Beyond acute treatment, long-term antiviral prophylaxis plays a major role in suppressing viral reactivation and preventing disease recurrence. Despite being an extensively researched pathology, HSV keratitis remains a leading cause of infectious corneal blindness worldwide. Staying focused on recent diagnostic and therapeutic advancements is imperative for clinicians to optimize medical protocols and achieve the best possible outcomes for every patient.

PMID:
43017395
Bibliographic data and abstract were imported from PubMed on 12 Nov 2026.

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