Posters

Herpes keratitis activation following corneal alkali burn: case series

Poster Details

First Author: L.Karmona ISRAEL

Co Author(s):    H. Avizemer                    

Abstract Details

Purpose:

Herpes simplex virus keratitis is among the most common causes of blindness from infectious corneal disease. Various triggers, systemic and ocular, are commonly thought to be associated with viral activation. Epithelial insult has been known to reactivate herpetic keratitis, but there are no reports in the literature linking alkali corneal burns to HSV reactivation in the cornea. We would like to describe 2 cases of herpes keratitis activation after corneal alkali burn.

Setting:

Department of ophthalmology, The Edith Wolfson Medical Center, Holon , Israel

Methods:

A retrospective review of 2 cases of herpes keratitis activation after corneal alkali burn.

Results:

Herpes keratitis activation occurred following alkali chemical burn in two patients with no history of herpetic disease (one from detergent and one from euphorbia). Herpetic keratitis was suspected due to an unexpected clinical course, especially delayed epithelial healing. One case was confirmed by PCR testing. Both cases improved under antiviral coverage.

Conclusions:

Alkali ocular chemical burn can induce herpetic keratitis in patients with no history of herpetic eye disease. Epithelial trauma associated with possible corneal nerve stimulation could be part of the pathophysiological mechanism for herpes virus reactivation. The use of steroid drops could also be a risk factor. Clinical suspicion early in the disease course and proper treatment are critical in order to halt disease progression and obtain a favorable outcome in these frustrating cases.

Financial Disclosure:

None