Treatment of Interstitial Keratitis in Herpes Simplex Virus or Herpes Zoster Infection
Interstitial keratitis presenting in the setting of herpes simplex virus (HSV) or herpes zoster (HZV) infection represents a viral-mediated form of corneal stromal inflammation with a distinct clinical approach compared to non-infectious aetiologies.
Clinical Scenario
This protocol applies to patients with herpes simplex virus interstitial keratitis or herpes zoster interstitial keratitis. Identifying the specific viral cause — HSV versus HZV — is relevant to treatment selection, as the adjunctive antiviral agents differ between these two conditions.
Treatment Approach (Summary)
Viral-mediated interstitial keratitis typically responds to topical corticosteroids. Depending on whether HSV or HZV is the underlying cause, adjunctive antiviral therapy may be incorporated alongside corticosteroids — the specific antiviral agent is determined by the viral aetiology.
The complete regimen — including agent selection, dosing, and sequencing — is available in the full structured protocol.
References
- Similarly, most viral-mediated interstitial keratitis will respond briskly to the addition of topical corticosteroids, but may benefit from the adjunctive use of topical or systemic anti-virals, specifically trifluridine in Herpes Simplex-mediated interstitial keratitis or acyclovir/valacyclovir in Herpes simplex and Herpes Zoster.
- They are the primary therapy for syphilitic interstitial keratitis, most immune forms of interstitial keratitis, and are used either in conjunction with antivirals (Herpes Simplex, Herpes Zoster) or alone in the viral-mediated interstitial keratitis.
View source ↗