Herpetic corneal epithelial disease
R. J. Marsh, F. T. Fraunfelder and J. I. McGill
The clinical differentiation of corneal epithelial lesions due to herpes
simplex or herpes zoster may be confusing. Practical clinical tests,
including the use of topical ocular stains, are useful to differentiate
corneal epithelial lesions caused by these two viruses. Two distinctive
types of zoster corneal epithelial disease may be seen; an early dendritic
form, and a delayed form characterized by corneal mucus plaques that may
take a dendriform pattern. These plaques are composed of mucus that is
adherent to swollen, degenerating epithelial cells. The clinical
differentiation between these two viruses is essential since topically
applied corticosteroids are contraindicated in epithelial herpes simplex
and often are indicated in the management of epithelial herpes zoster.