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Herpes Simplex keratitis (HSK) is a viral infection that if left untreated can have devastating ocular consequences. Approximately 90% of the population over the age of 15 has been exposed to the type I herpes virus. It is the secondary herpetic infection, acute secondary herpes keratitis, which is more troubling for the eye.
Secondary herpetic infections mainly affect the cornea producing what is called a dendritic keratitis or branching pattern.
This herpes simplex virus is contagious and can be transmitted by skin contact with others and from one part of the body to another (i.e.
After the primary infection in childhood, the virus tends to remain dormant within the nerves of the body, especially the trigeminal nerve. The drop most often used for this condition is Viroptic® (generic: trifluridine), a potent antiviral agent.

A recent study published in the Archives of Ophthalmology (Aug 98) reports that the use of oral medications such as Zovirax for one year following the HSV episode, greatly reduces the rate of re-occurrence.
The primary exposure to the virus may cause multiple whitish blisters around the eye termed viral eczema. The virus may become reactivated during emotional or physical stress, overexposure to ultraviolet light (i.e. Vira A® (generic: vidarabine), an ophthalmic ointment may also be used in combination with Viroptic or on its own for the primary form of the disease. In some instances, systemic antiviral medications such as Zovirax® (generic: acyclovir) or Valtrex may also be used.
The acute primary herpetic infection is generally self limiting, meaning that within a given period of time, the infection resolves without any treatment or medical intervention.
It is important to note that topical steroid medications, at least initially, are contraindicated in the treatment of this dendritic keratitis.

There are approximately 700,000 new cases of herpes simplex epithelial keratitis in the United States each year. Steroids such as dexamethasone found in Tobradex and prednisolone acetate may promote the growth and expansion of the ocular surface disease. Prior to abusing the toddler, Wilson sexually molested a 14-year-old girl for over two years and ended up getting her pregnant.

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