Viral Keratitis, Surgical Intervention in Viral Keratitis, Challenges in Diagnosis and Treatment of Viral Keratitis, HSV, HZV

Viral keratitis is a significant cause of ocular morbidity and visual impairment worldwide. In recent years, there has been a growing understanding of the pathogenesis, clinical manifestations, and diagnostic modalities for viral keratitis. The most common viral pathogens associated with this condit...

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Published in:Seminars in ophthalmology 2024-07, Vol.39 (5), p.340-352
Main Authors: Venugopal, Anitha, Christy, Josephine, Raut, Vaidehi, P, Preethi, Patwardhan, Veena, V, Veeramma, Madkaikar, Aditee, P, Mangala, Meenakshi, Ravindran, Ramakrishnan, Rangappa
Format: Article
Language:English
Subjects:
Antiviral Agents - therapeutic use
Eye Infections, Viral - diagnosis
Eye Infections, Viral - drug therapy
Eye Infections, Viral - surgery
Eye Infections, Viral - virology
Herpes Zoster Ophthalmicus - diagnosis
Herpes Zoster Ophthalmicus - drug therapy
Herpes Zoster Ophthalmicus - virology
Humans
Keratitis, Herpetic - diagnosis
Keratitis, Herpetic - drug therapy
Keratitis, Herpetic - surgery
Keratitis, Herpetic - virology
Ophthalmologic Surgical Procedures - methods
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Summary:Viral keratitis is a significant cause of ocular morbidity and visual impairment worldwide. In recent years, there has been a growing understanding of the pathogenesis, clinical manifestations, and diagnostic modalities for viral keratitis. The most common viral pathogens associated with this condition are adenovirus, herpes simplex (HSV), and varicella-zoster virus (VZV). However, emerging viruses such as cytomegalovirus (CMV), Epstein-Barr virus (EBV), and Vaccinia virus can also cause keratitis. Non-surgical interventions are the mainstay of treatment for viral keratitis. Antiviral agents such as Acyclovir, Ganciclovir, and trifluridine have effectively reduced viral replication and improved clinical outcomes. Additionally, adjunctive measures such as lubrication, corticosteroids, and immunomodulatory agents have alleviated symptoms by reducing inflammation and facilitating tissue repair. Despite these conservative approaches, some cases of viral keratitis may progress to severe forms, leading to corneal scarring, thinning, or perforation. In such instances, surgical intervention becomes necessary to restore corneal integrity and visual function. This review article aims to provide an overview of the current perspectives and surgical interventions in managing viral keratitis. The choice of surgical technique depends on the extent and severity of corneal involvement. As highlighted in this article, on-going research and advancements in surgical interventions hold promise for further improving outcomes in patients with viral keratitis.
ISSN:0882-0538
1744-5205
DOI:10.1080/08820538.2024.2309533