Term
| Herpes Simplex Epithelial Keratitis |
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Definition
| HSV-1; Oral Infection: Epithelial a. Replicates in corneal epithelium only b. Dendnrite as a result of epithelial cell destruction; Stromal – viral antigens diffuse into strom stimulating Ag-Ab rx causing stromal edema and permeability that leads to opacification and necrosis in severe cases; Netrotrophic Ulcer a. Structural damage to the basement membrane causing sterile ulcer, b. Persist even with therapy that may lead to corneal melting and perforation . |
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Term
| Herpes Simplex Epithelial Keratitis Signs |
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Definition
| Earliest lesions are small clear raised vesicles in the epithelium; Within 24 hrs. lesions coalesce to form the dendritic and geographical ulcers, Initially true dendrites might only stain with NaFL in the middle; Swollen Border (raised) w/ live virus stain w/ Rose Bengal; Healing dendrite can leave a typical “footprint” scar (subepithelial) |
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Term
| Treatment for Herpes Simplex Epithelial Keratitis |
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Definition
| 1. Trifluridinen (DOC) 2. Idoxuridine (IDU), Vidarabine |
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Term
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Definition
| ttmt. for Herpes Simplex Epithelial Keratitis, Analog of thymidien, Phosphorylated by viral and host thymidine kinase, Mode of action: a. Inhibition thymidine synthase in viral and host cells, b. Incorporates into viral DNA chain; 1 % ophthalmic solution (viroptic); Drug of Choice; Side effects: Epithelial defects, Recurrent corneal erosion, Transient burning sensation (chemosis and hyperemia) |
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Term
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Definition
| ttmt. for Herpes Simplex Epithelial Keratitis; Nitrogenous compound similar to thymidine; Phosphorylated by host cell and viral thymidine kinase, Excessive toxicity if used systemically, 0.1% ophthalmic solution and 0.5% ophthalmic ointment; Side effects: Superficial Punctate Keratitis (SPK), Corneal Ulceration, Stromal Opacification – Cytoxocity, |
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Term
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Definition
| ttmt. for Herpes Simples Epithelial Keratitis; Analog of adensine, Phosphorylated by viral andn host’s cell kinase, Mode of action: Inhibits DNA polymerase, Predilection for viral polymerase 3% ophthalmic ointment; Primarily used in stage 1 herpes keratitis; Adjunct treatment in zoster ophtalmicus; Side effects similar to idoxuridine but less toxic |
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Term
| Herpes Zoster Ophthalmicus |
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Definition
| Reactivation of Varicella virus (chickenpox in childhood);Peak age 50-70 year old; In young patients: r/o HIV; Affects 1st. dive CNV: Fronntal ( upper lid, sup. conjuncitva, forehead); if Nasociliary (globe) (Hutchinsonn sign) so more prob. of ocular inv. (corneal |
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Term
| Herpes Zoster Opthalmicus Signes |
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Definition
| Erythematous vesicles respecting midlen, which after a few days crust; Follicular reaction, lympadenopathy; Associated ocular – small pseudodendrites or non-specific SPK |
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Term
| Treatment for Herpes Zoster Ophthalmicus |
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Definition
| Adult w/ acute mod-severe rash and onset of 72 hours or less, Palliative for lesions – warm compress; Antibiotic topical ung for 2ry infection; Corneal pseudodendrites or SPK; artificial tears q 1-2h and ung (refresh plus, Refresh PM); Acyclovir |
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Term
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Definition
| Treatment for Herpes Zoster Ophthalmicus; Analogue of guanosine; Phosphorylated by viral thymidine kinase only; Mode of action – inhibits viral DNA polyermase; 200 |
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