Keratitis

Symptoms: ocular pain, blurry vision, redness (more common to have blepharoconjunctivitis than with corneal involvement)

Diagnosis:

1. Anesthetize the eye
2. Add fluorescein staining
3. Use Cobalt blue light on slit lamp
4. Look for terminal bulbs on the dendrites (Herpes zoster pseudodendrites don’t have terminal bulbs)

Treatment: Oral and/or Topical antivirals

• Oral: 10-14 days of Acyclovir, Valacyclovir, Famciclovir
• Topical: Ganciclovir 0.15% drops 5X / day until cornea healths then 3X/day for another week

Discharge Instructions

• Ophthalmology follow up in 24 hours

Symptoms: bilateral eye pain, decreased vision 30 minutes - 12 hours after exposure

Diagnosis:

1) Anesthetize the eye

2) Add fluorescein staining

3) Use Cobalt blue light

4) Superficial punctate keratitis where epithelium has been sloughed off, conjunctival injection spares the palpebral conjunctival because eyelids are protective

Treatment:

Antibiotic ointment: bacitracin or erythromycin ophthalmic ointments every 8 hours

Discharge Instructions

Ophthalmology follow-up in 24 hours

Dark glasses to block UV light