TREATMENT

NUHA AYISHA NV
 Viral Keratitis

2. HZ
1. HS keratitis
ophthalmicus

10 Recurrent Systemic Local Surgical

Epithelial Stromal Meta herpetic

 I. Herpes Simplex Keratitis
1)1⁰ Ocular Herpes
Self limiting

2)Recurrent Ocular Herpes

A. Epithelial Keratitis
Specific & Nonspecific Treatment
Specific Treatment
Topical Systemic Antiviral Mechanical
Antiviral drugs drugs Debridement
• Acyclovir 3% • Acyclovir • Resistant
ointment 400mg bd • Noncompliance
• Ganciclovir 0.15% • Famcyclovir • Allergy
gel 250mg bd
• Vidarabine 3% • Valacyclovir
ointment 500mg bd
• Triflurothymidine
1% drops
 Non specific treatment
Cycloplegics-1% atropine ointment/drops
Systemic analgesics
Anti inflammatory drugs

Hot fomentation
Dark goggles
Rest,good diet and fresh air
- B. Stromal keratitis-disciform

• Dil. Steroid eye drops( 5 times/day)

• Acyclovir 3% bd
• If infective ulcer + →Antivirals started 7 days before steroids

B. Stromal keratitis-necrotic

• Similar but unsatisfactory

• Recurrent, associated uveitis→ Systemic antivirals*10-21
days
• Keratoplasty
C. Metaherpetic keratitis
Promote healing
Artificial tears, contact lens, tarsorrhaphy
II. Herpes Zoster Ophthalmicus

c) Local
a) Systemic
therapy for
Therapy
skin lesions

b) Local
d) Surgical
therapy for
treatment
ocular lesions
a) Systemic Therapy
• Oral Antiviral Drugs
1. • Acyclovir 800 mg
• Valacyclovir 500 mg

2. • Analgesics

3. • Systemic steroids

4. • Cimetidine

5. • Amitriptyline
 b) Local therapy for ocular lesions
Keratitis, iridocyclitis, scleritis
• Steroid eye drops qid
• Cycloplegics
• Acyclovir 3% ointment
Topical Antibiotics-prevent 20 infections
20 glaucoma
• Timolol/betaxolol drops
• Acetazolamide
Mucous plaques
• Acetyl cysteine
Epithelial defects
• Artificial e/d
• Bandage soft contact lens

c) Local therapy for skin lesions

• Antibiotic-corticosteroid skin ointment/lotions-tid
d) Surgical treatment

Amniotic
Lateral
Membrane
tarsorrhaphy
Transplatation

Tissue
Keratoplasty
adhesive