Herpetic keratoconjunctivitis: Difference between revisions
No edit summary |
Varun Kumar (talk | contribs) |
||
| Line 32: | Line 32: | ||
[[Category:Viral diseases]] | [[Category:Viral diseases]] | ||
[[Category:Virus-related cutaneous conditions]] | [[Category:Virus-related cutaneous conditions]] | ||
[[Category: | [[Category:Ophthalmology]] | ||
[[Category:Optometry]] | [[Category:Optometry]] | ||
{{WikiDoc Help Menu}} | {{WikiDoc Help Menu}} | ||
{{WikiDoc Sources}} | {{WikiDoc Sources}} | ||
Revision as of 01:18, 7 August 2011
| Herpesviral ocular disease | |
| Advanced herpes infection of the cornea | |
| ICD-10 | B00.5 |
|---|---|
| ICD-9 | 054.4 |
| MeSH | D016849 |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Please Take Over This Page and Apply to be Editor-In-Chief for this topic: There can be one or more than one Editor-In-Chief. You may also apply to be an Associate Editor-In-Chief of one of the subtopics below. Please mail us [2] to indicate your interest in serving either as an Editor-In-Chief of the entire topic or as an Associate Editor-In-Chief for a subtopic. Please be sure to attach your CV and or biographical sketch.
Herpetic keratoconjunctivitis is a form of keratitis and conjunctivitis associated with herpes simplex virus.[1]:370
It begins with infection of epithelial cells on the surface of the eye and retrograde infection of nerves serving the cornea.[2] Primary infection typically presents as swelling of the conjunctiva and eye-lids (blepharoconjunctivitis), accompanied by small white itchy lesions on the surface of the cornea. The effect of the lesions varies, from minor damage to the epithelium (superficial punctate keratitis), to formation of dendritic ulcers.[3] Infection is unilateral, affecting one eye at a time. Additional symptoms include dull pain deep inside the eye, mild to acute dryness, and sinusitis. Most primary infections resolve spontaneously in a few weeks. Healing can be aided by the use of oral and topical antivirals.
Subsequent recurrences may be more severe, with infected epithelial cells showing larger dendritic ulceration, and lesions forming white plaques.[3] The epithelial layer is sloughed off as the dendritic ulcer grows, and mild inflammation (iritis) may occur in the underlying stroma of iris. Sensation loss occurs in lesional areas, producing generalised corneal anaesthesia with repeated recurrences.[3] Recurrence can be accompanied by chronic dry eye, low grade intermittent conjunctivitis, or chronic unexplained sinusitis. Following persistent infection the concentration of viral DNA reaches a critical limit. Antibody responses against the viral antigen expression in the stroma can trigger a massive autoimmune response in the eye. The response may result in the destruction of the corneal stroma,[3] resulting in loss of vision due to opacification of the cornea. This is known as immune-mediated stromal keratitis.
References
- ↑ James, William D.; Berger, Timothy G.; et al. (2006). Andrews' Diseases of the Skin: clinical Dermatology. Saunders Elsevier. ISBN 0-7216-2921-0.
- ↑ Carr DJ, Härle P, Gebhardt BM (2001). "The immune response to ocular herpes simplex virus type 1 infection". Exp. Biol. Med. (Maywood). 226 (5): 353–66. PMID 11393165.
- ↑ 3.0 3.1 3.2 3.3 Suresh PS, Tullo AB (1999). "Herpes simplex keratitis". Indian J Ophthalmol. 47 (3): 155–65. PMID 10858770.