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Natural History and Treatment of Epithelial Ulcers in Tunisia

John P. Whitcher, MD; Chandler R. Dawson, MD; Isao Hoshiwara, MD; Toufique Daghfous, MD; Mohammed Messadi, MD; Fethi Triki, MD; Jang O. Oh, PhD

Arch Ophthalmol. 1976;94(4):587-592.

Abstract
• Herpes simplex keratitis was found to be a common ophthalmic problem in Tunisia. Dendritic and geographic ulcers were complicated by deep stromal keratitis in 31 % of patients, two thirds of whom were known to have been treated previously with corticosteroids. Herpes simplex virus was isolated from 41% of patients from whom corneal material wascultured. To develop an effective program for management of epithelial herpes in developing countries, treatment with idoxuridine was compared with debridement and patching. Average healing time for 31 ulcers treated with idoxuridine was 13 days, with three treatment failures; average healing time for 20 ulcers treated with debridement and patching was five days, with one failure. Debridement and patching of herpetic ulcers was an efficient way to treat herpes simplex keratitis within the context of overall medical care in Tunisia.

Author Affiliations
From the Francis I. Proctor Foundation for Research in Ophthalmology, University of California, San Francisco (Drs Whitcher, Dawson, and Oh); l'Institut d'Ophtalmologie, Tunis, Tunisia (Drs Daghfous, Messadi and Triki); and the Division of Indian Health, Public Health Service Phoenix, Ariz (Dr Hoshiwara).

Footnotes
Submitted for publication Jan 31, 1975.

Reprint requests to Francis I. Proctor Foundation, University of California, San Francisco, CA 94143 (Dr Dawson).

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