Herpes simplex virus infection keratitis with

Antiviral Efficacy and Clinical Use. Trifluridine (Viroptic) is administered by eye drops to treat local eye infections associated with herpes simplex virus that is, herpes virus-related keratitis and keratoconjunctivitis.42... 

Vidarabine [vye DARE a been] arabinofuranosyl adenine, ara-A, adenine arabinoside) is one of the most effective of the nucleoside analogs and is also the least toxic. However, it has been supplanted clinically by acyclovir, which is more efficacious and safe. Although vidarabine is active against herpes simplex virus type 1 (HSV-1), HSV-2, and varicella-zoster virus (VZV), its use is limited to treatment of immunocompromised patients with herpes simplex keratitis or encephalitis, or VZV infections. Vidarabine, an adenosine analog, is converted in the cell to its 5 -triphosphate analog (ara-ATP), which is postulated to inhibit viral DNA synthesis. Some resistant herpes virus... 

Herpesviruses range in size from 120 to 300 nm and have DNA genomes and outer lipid membranes (envelopes). As enveloped viruses, herpesviruses are sensitive to drying and adverse conditions. Herpesviruses are spread by inoculation of susceptible mucous membranes or direct cell-to-cell contact. Over 100 herpesviruses have been identified, but only 5 cause human eye infections with any frequency herpes simplex virus-1 (HSV-1), herpes simplex virus-2 (HSV-2), varicella zoster virus (VZV), cytomegalovirus (CMV), and Epstein-Barr virus. Herpesviruses can cause blepharitis, conjunctivitis, epithelial and stromal keratitis, uveitis, retinitis, and ARN. HSV-1 is the most frequent cause of primary and recurrent eye disease. The host immime system influences the rates of reactivation. Immimocompromised patients tend to have more frequent reactivations and more severe disease manifestations. The strain of virus also affects the... 

Herpes Simplex Virus Ophthalmia Neonatorum. HSY infection is an uncommon but important cause of neonatal infection and is associated with conjunctivitis in 5% to 10% of cases.The clinical manifestations are nonspecific and include conjimctival hyperemia, chemosis, periorbital edema, and mucous discharge. Corneal involvement is not uncommon and can include dendritic, geographic, or stromal keratitis. Herpetic ophthalmia neonatorum represents a primary herpetic infection. Central nervous system involvement, encephalitis, retinitis, optic neuritis, uveitis, choroiditis, and a fetal viremia can be serious sequelae of primary herpetic infections. 

Although serious infections have been reported following deep peels, including bacterial pyodermas, toxic shock syndromes and Epstein Barr virus keratitis, I have to date only observed two types of infectious complication (1) Herpes simplex, which has been virtually eradicated by the use of prophylactic antiviral medications. The onset of herpes is often heralded by increasing pain, and (2) superficial pyoderma, which is often associated with poor postoperative wound care. 

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