HSV Dendritic Epithelial Keratitis
- Begins as discrete punctate epithelial keratitis which may then coalesce to form dendritic-shaped lesions.
- May be single or multiple, with typical "terminal bulb" at the tips of dendrite branches.
- Devitalized cells surrounding the edge of the dendritic ulcers best stained with rose bengal.
- Fluorescein dye may pool in the central ulceration of epithelial dendrites
- Unilateral and 10% bilateral.
- Symptoms: tearing, foreign body sensation, photophobia, ocular pain and blurring of vision
- First present as punctate keratitis that may become progressive
- Pathognomonic single or multiple branching dendritic ulcers possibly progressing to wider geographic ulcers
- May present also as stromal keratitis, endothelitis, uveitis and retinitis
- individually or in combination
- Topical antivirals
- Systemic antivirals