Stromal. Stromal involvement accounts for 20% to 25% of presentations4 and may cause significant anterior chamber inflammation. Vision loss can result from permanent stromal scarring.5
Endotheliitis. Keratic precipitates (on top of stromal and epithelial edema) and a mild-to-moderate iritis are signs of endotheliitis.5
Neurotrophic keratopathy. This form of HSV keratitis is associated with corneal hypoesthesia or complete anesthesia secondary to damage of the corneal nerves, which can occur in any form of ocular HSV. Anesthesia may lead to nonhealing corneal epithelial defects.6 These defects, which are generally oval lesions, do not represent active viral disease and are made worse by antiviral drops. These lesions may cause stromal scarring, corneal perforation, or secondary bacterial infection.
Treatment consists of supportive care using artificial tears and prophylactic antibiotic eye drops, if appropriate; more advanced ophthalmologic treatments may be needed for advanced disease.7
Continue to: Other conditions, including conjunctivitis, have similar symptoms