Mucous plaque keratitis

The dendritic corneal lesions of HZO are more superficial, smaller, and have blunter ends than do the dendrites caused by herpes simplex, which often have terminal bulbs (Table 26-6). They usually occur 4 to 6 days after the skin vesicles erupt and stain moderately well with rose bengal and NaFl (Figure 26-49). In addition to dendritic keratitis, mucous plaque keratitis may also occur almost anytime in the course of the disease but typically occurs... 

Figure 26-50 Mucous plaque keratitis associated with herpes zoster. (A) Initial presentation. (B) Note migratory nature of lesions 3 weeks later. (Courtesy Marc A. Michelson, MD.)...

Mucous plaque keratitis can be treated with 10% acetylcysteine but also resolves without treatment. Keeping the eye moist with artificial tears may be helpful. Exposiue keratitis and neruotropic keratitis are best treated with artificial tears, lid taping at bedtime, and, if necessary, tarsorrhaphy. Therapeutic contact lenses should not be used because of the risk of developing infectious ulcers in an eye with decreased sensitivity. 

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