TRAFFIC ADVISORY:

President Trump is scheduled to be in Philadelphia on Tuesday, September 15, 2020 at The National Constitution Center (NCC) in the Independence Mall area. Increased police presence is anticipated in Center City throughout Tuesday afternoon and evening. Please allow extra time if you are going to Wills Eye. Please be advised of area street closures to vehicles beginning at 1:00PM on Tuesday 9/15. Pedestrian access will also be limited in the area. This is subject to change and area restrictions, which could widen, will be lifted once the President departs the NCC. There are also demonstrations planned for Tuesday 9/15 around Independence Mall as well as City Avenue.

Herpes Simplex Keratitis

Overview

The herpes simplex type 1 virus is the same virus that causes cold sores in and around the mouth, where it can be annoying, but not generally a major problem.  Unfortunately, the virus can also affect the cornea, which can cause temporary or permanent decreased vision, and also glaucoma. It may present as an active infection in the cornea (dendritic keratitis or stromal keratitis), active inflammation (disciform keratitis), or both. Active infection is treated with antiviral medications (drops, gels, ointments, or pills) and active inflammation may be treated with steroid drops. Often the medications, especially steroids, are decreased slowly, typically over many months to years. Herpes keratitis can recur. To decrease the risk of multiple recurrences, antiviral pills may be used for years.

Symptoms

Pain, redness, discharge, decreased vision. Often a history of previous episodes of ocular redness and inflammation.

Causes

Typically the herpes simplex type 1 virus. It is the same virus that causes cold sores in and around the mouth, where it can be annoying, but not generally a major problem. Unfortunately, the virus can also affect the cornea.

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Risk Factors

Prior herpes simplex keratitis. Stress, sunlight exposure, and others factors may increase the risk of recurrences.

Complications

Corneal scarring, glaucoma, cataract, severe decreased vision or blindness.

Tests and Diagnosis

Slit lamp examination with special staining such as fluorescein dye is essential. Corneal viral cultures can be done, but are not commonly performed.

Treatment

Active infection is treated with antiviral medications (drops such as trifluridine, gel such as ganciclovir, ointment such as acyclovir or pills such as acyclovir, valacyclovir or famciclovir). Active inflammation, when severe enough, can be treated with steroid drops. Often the medications, especially steroids, are decreased slowly, typically over many months or years. Herpes keratitis (infectious or inflammatory) can recur. To decrease the risk of recurrence, antiviral pills may be used for years.

Prevention

Oral anti-viral medications can significantly decrease the risk of recurrence.

 

Wills Eye Cornea Specialists

 

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