Clinical Pattern And Visual Impairment Associated With Herpes Simplex Keratitis
Received 12 June 2019
Accepted for publication 17 October 2019
Published 12 November 2019 Volume 2019:13 Pages 2211—2215
Checked for plagiarism Yes
Review by Single-blind
Peer reviewers approved by Dr Melinda Thomas
Peer reviewer comments 2
Editor who approved publication: Dr Scott Fraser
Anica Shah, Purushottam Joshi, Bijaya Bhusal, Prabha Subedi
Department of Cornea, Mechi Eye Hospital, Birtamode, Nepal
Correspondence: Anica Shah
Department of Cornea, Mechi Eye Hospital, 9 Sainikmode, Nepal
Tel +97 798 0331 9327
Purpose: Herpes simplex keratitis (HSK) has varied presenting patterns, and is one of the leading causes of corneal scarring and subsequent visual disability. This study was carried out to determine the incidence and patterns of HSK presenting at a tertiary eye center in eastern Nepal and to assess the associated visual impairment.
Methods: This was a descriptive, cross-sectional study at a tertiary eye-care center that included 302 cases of clinically diagnosed HSK over a period of 1 year. Detailed ocular examination was done in all patients. Clinical manifestations and visual acuity at presentation and on subsequent visits in cases that followed up were recorded. Findings were noted in structured format and later assessed.
Results: Of 302 cases of HSK, 53 presented with epithelial keratitis, 156 with stromal keratitis without ulceration, 22 with stromal keratitis with ulceration, 66 with endothelitis, and five with neurotrophic ulcers. Presenting visual acuity in 108 patients (35.7%) was <3/60. Of 175 patients who followed up, 36 patients continued to have vision <3/60.
Conclusion: This study shows that HSK has diverse presentation and can cause significant vision impairment. Stromal keratitis without ulceration was the most common presentation in our study. In developing nations, due to higher incidence of fungal and bacterial keratitis, HSK is not studied much. Few epidemiological data are available on the subject, and since the disease is notorious for recurrence, long-term study is paramount to estimate the burden of visual morbidity caused by the disease.
Keywords: herpes simplex keratitis, viral keratitis, herpes simplex
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