HSV herpetic dendritic ulcer on cornea (Video)

This video shows the classic dendritic ulcer seen with HSV keratitis. You can see them easily with the use of fluorescein staining (that’s why everything is blue in the movie). These patients typically present with a painful, red eye with photophobia. The HSV is typically the type-1 hsv infection that most people are inoculated with (HSV1 is the cause of cold-sores) and is thus not a sexual infection.

Treatment involves topical viroptic and possibly systemic antivirals if recurrent. You definitely DON’T want to treat this with steroids as this can increase viral replication and lead to terrible geographic ulcers.

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hsvdendriticulcer.wmv (4.6 meg, Windows video file)

Screencaptures

HSV Dendritic Ulcer
This slit-lamp photograph shows a HSV dendritic lesion on the corneal surface of the eye. These lesions occur in the superficial epithelial layer of the cornea … if you look closely at the slit-lamp light beam, you’ll see that only the surface portion lights up (no corneal thinning).
Herpes Dendrites
This photo shows the classic dendritic ulcer that you see on the cornea of the eye with herpetic keratitis. The ulcer has branching, bulbous extensions and as you can see here, lights up with fleuroscein.
HSV keratitis
This photo shows the classic dendritic ulcer that you see on the cornea of the eye with herpetic keratitis. The ulcer has branching, bulbous extensions and as you can see here, lights up with fleuroscein.
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Dr. Timothy Root is a practicing ophthalmologist and cataract surgeon in Daytona Beach, Florida. His books, video lectures, and training resources can be found at:

3 COMMENTS

  1. DearSirs,
    I am currently suffering with anulcer like this.
    The dr. prescribed Zovirax ointment.
    However, each time I apply the salf the ey pains even more than before and the vision is now completely impaired.
    Is there any other treatment available??

    Sincerely,
    Michelle Williams

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