Among the viral keratitis most often affects the cornea of the herpes virus. Common to all viral infections is that they are always accompanied by damage to the nervous tissue, which shows a violation of the innervation of the cornea and decrease its sensitivity. Often, viral keratitis occur for a long time and very often recur.
Primary herpetic keratitis. Primary herpetic keratitis occur in children under five. This is the first clash of the body with herpes infection. Disease is acute and usually begins with the eruption of herpetic vesicles on the skin of the trunk, arms, legs, face and conjunctiva of the eye. Patients complain of eye pain, tearing, discomfort when looking at the light, blurred vision, redness of the eyes.
Corneal opacities appear small foci, then the bubbles. In place of the bubbles will soon develop erosion and ulcers. In the inflammatory process often involves the iris. Quite often, if time does not heal keratitis associated to the inflammatory process and bacterial infection can develop purulent process. After the acute inflammation subsided in the cornea remain stable turbidity. The process can take place in waves, then dying away, the sharpening or recurring - re-emerge after recovery.
Poslepervichny herpetic keratitis. Poslepervichny herpetic keratitis occurs in children, usually after three years earlier undergone chickenpox or adults on the background of a weakened immune system. Patients complain of blepharospasm (spasmodic closure century), tearing, cutting pains in the eyes mist. When poslepervichnyh herpetic lesions on the skin rash usually does not happen.
Herpes simplex virus can affect all layers of the cornea. Superficial lesion of the cornea appears vesicular keratitis. The cornea in any of the department having little gray bubbles that then burst to form ulcers. Ulcers may heal slowly and in their place are small opacities. If the sores are merged together, formed first strokes and pyatyshki, then, in turn, these structures are interconnected and form a characteristic shape, similar to tree branches. There is a dendritic keratitis, which is still superficial.
Course of the disease for a long, recurrent. Deeper corneal damage occurs when the herpes infiltrates are deeper in the tissue of the cornea. Usually in this case they are distributed over a large area. The cornea becomes cloudy and gray. Vision deteriorates. Often the process involves the iris and iritis or iridocyclitis occurs. Once the acute process of damping in the cornea is marked turbidity could affect vision.
Disciform keratitis - a loss of deep divisions of the corneal tissue to form in the center of the corneal infiltrate in the form of a disk. Disciform keratitis accompanied by enhanced inflammatory response, significant swelling of the cornea, conjunctiva, eyelids. Sight impaired greatly. Disciform keratitis can easily spread to the iris, ciliary body and can lead to increased intraocular pressure.
Treatment of herpetic keratitis.
It is best to treat viral keratitis in the hospital. Appointed by the antiviral drugs as a form of eye drops and ointments, and oral (acyclovir, valacyclovir, idoxuridine). Appointed by the drug increases the body's defense antiviral interferon Poludanum, deoxyribonuclease. Because herpetic keratitis accompanied by considerable pain, appointed by the instillation into the eyes of local anesthetics (lidocaine). For the prevention of bacterial infection, sometimes an antibiotic is prescribed. For the treatment of corneal opacities after suffering herpetic keratitis often have to resort to keratoplasty.
Keratitis caused by herpes zoster virus. Herpetic keratitis occurs in lesions of the virus Herpes soster first branch of the trigeminal nerve. In the area of innervation of the first branch of the trigeminal nerve - in the forehead, eyelids pour herpetic blisters. Similar bubbles are formed on the cornea. The disease is accompanied by severe pain in places rash. Vesicles on the cornea can be superficial, is a small foci of corneal opacity, sometimes ulcerated cornea.
In this disease there is a risk involved in the process of iris, optic nerve, the nerves that innervate the eye muscles. There may be a paralysis of eye muscles or secondary glaucoma. Visual acuity is reduced, often permanently. After damping the acute process, many patients are still in great pain, which analgesics are not removed.
Treatment of keratitis caused by the herpes zoster. For the treatment of keratitis primarily assigned to antiviral drugs in large doses orally (acyclovir 800 mg 5 times daily), acyclovir drop, deoxyribonuclease. For pain treatment is assigned karbomazepin antiepileptic drug.
