scholarly journals The Herpetic Eye Disease Study: Topical Corticosteroid Trial for Herpes Simplex Stromal Keratitis: A Paradigm Shifting Clinical Trial

Ophthalmology ◽  
2020 ◽  
Vol 127 (4) ◽  
pp. S3-S4
Author(s):  
James Chodosh
Keyword(s):  
Clinical Trial ◽  
Herpes Simplex ◽  
Topical Corticosteroid ◽  
Eye Disease ◽  
Stromal Keratitis ◽  
Disease Study ◽  
Paradigm Shifting

Topical Corticosteroids for Herpes Simplex Stromal Keratitis

2020 ◽  
pp. 9-14
Author(s):  
Alan D. Penman ◽  
Kimberly W. Crowder ◽  
William M. Watkins
Keyword(s):  
Herpes Simplex ◽  
Acute Treatment ◽  
Visual Outcome ◽  
Eye Disease ◽  
Controlled Clinical Trial ◽  
Study Enrollment ◽  
Topical Corticosteroids ◽  
Stromal Keratitis ◽  
Disease Study ◽  
Therapy Treatment

The Herpetic Eye Disease Study (HEDS) was a randomized, double-masked, placebo-controlled, clinical trial to determine the efficacy of topical corticosteroids as adjunctive therapy in the treatment of herpes simplex stromal keratitis in patients who had not received any corticosteroids for at least 10 days before study enrollment. The study showed that topical corticosteroids can be used judiciously with protective antiviral cover in the acute treatment of patients with herpes simplex stromal keratitis who have not recently received corticosteroid therapy. Treatment reduced persistence or progression of stromal inflammation and shortened the duration of herpes simplex stromal keratitis. Postponing steroids during careful observation for a few weeks delayed resolution of stromal keratitis but did not worsen visual outcome at 6 months.

scholarly journals Reactivation of herpes simplex keratitis following vaccination for COVID-19

2021 ◽  
Vol 14 (9) ◽  
pp. e245792
Author(s):  
James Richardson-May ◽  
Alice Rothwell ◽  
Mohammed Rashid
Keyword(s):  
Visual Acuity ◽  
Herpes Simplex ◽  
Eye Disease ◽  
Personal Health ◽  
Herpetic Stromal Keratitis ◽  
Corneal Scarring ◽  
History Of ◽  
Stromal Keratitis ◽  
Herpes Simplex Keratitis ◽  
Prompt Diagnosis

An 82-year-old man with a history of herpes simplex keratitis 40 years previously presented with recurrence, 1 day following vaccination for novel COVID-19. His condition worsened despite topical treatment with ganciclovir gel. A diagnosis of herpetic stromal keratitis was made, requiring systemic aciclovir, topical prednisolone, moxifloxacin and atropine, and oral doxycycline. He improved clinically on treatment, with some residual corneal scarring. Visual acuity improved from 6/36 corrected at presentation, to 6/24 following treatment. Clearly, public and personal health benefits from vaccination are hugely important and we would not suggest avoiding vaccination in such patients. It is, however, important for ophthalmic providers to be aware of the rare potential for reactivation of herpetic eye disease following vaccination to enable prompt diagnosis and treatment.

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