HERPES SIMPLEX DENDRITIC ULCER
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HERPES SIMPLEX DENDRITIC ULCER Prepared by: Nutrimala Nadia Nasip Ulfa Nur Izzati Abd. Wahid Deena Khairiah Baharuddin Siti Nur Hazwanti Hamzah Ophthalmology department 4 th year Zagazig University
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HERPES SIMPLEX DENDRITIC ULCER. Prepared by: Nutrimala Nadia Nasip Ulfa Nur Izzati Abd . Wahid Deena Khairiah Baharuddin Siti Nur Hazwanti Hamzah Ophthalmology department 4 th year Zagazig University. INTRODUCTION. - PowerPoint PPT Presentation
Transcript of HERPES SIMPLEX DENDRITIC ULCER
HERPES SIMPLEX DENDRITIC ULCERPrepared by:
Nutrimala Nadia NasipUlfa Nur Izzati Abd. Wahid
Deena Khairiah BaharuddinSiti Nur Hazwanti Hamzah
Ophthalmology department4th year Zagazig University
INTRODUCTION It is a primary, superficial, infective
ulcer having a dendritic shape caused by Herpes Simplex Virus (epitheliotropic type).
Dendritic ulcer stained with fluorescin
Herpes Simplex virus
PATHOPHYSIOLOGY
Primarily responsible, above waistOrofacial & ocular infection
HSV-1Transmitted sexually
Genital diseases, passed to neonates
HSV-2
Virus becomes dormant in trigeminal (V) ganglion
Inter-neuronal spread1ry HSV-1 infection; in childhood
Direct contact of skin or mucous membrane with virus-laden lesions or
secretions
PREDISPOSING FACTORS
Fever Menstruation
Drugs Psychic stress
Low resistance
Recurrence occurs with decreased body resistance
Virus becomes active
Vesicles in mouth, genitalia, cornea
Close-up view of early herpes outbreak shows small, grouped blisters (vesicles) and lots of inflammation (erythema).
FREQUENCY HSV infection is ubiquitous, with an
estimated one third of the population worldwide suffering from recurrent infections.
CLINICAL ASPECTS OF DENDRITIC ULCER
HISTORY Patients with HSV keratitis may
complain of the following:› Pain› Photophobia› Poor vision› Profuse lacrimation› Blepharospasm
SIGNS
Corneal stromal inflammation
Infectious epithelial keratitis
Endothelitis Blepharo-
conjunctivitis
DIAGNOSISRose bengal
Fluorescin
Mix
Dendritic ulcer stained with fluorescin
Dendritic ulcer stained with Rose Bengal
COMPLICATIONS
Eye infection
Throat infection
Eczema herpeticum
Erythema multiform
Nervous system
Widespread infection
DIFFERENTIAL DIAGNOSIS
Bacterial & fungal keratitis
Peripheral ulcerative keratitis
Superficial punctate keratitis
Acant
hamoeba
ker
atiti
s
Photokeratitis
Int
er
stiti
al
ker
atiti
s
TREATMENT
Local•Antiviral (acyclovir)•Atropine•Local antibiotic•Bandage
General•Vit A & Vit C•Acyclovir tablet
Resistant •Debridement•Cauterization•Therapeutic keratopathy
Thank You
