Corneal dendritic changes

Dendritic keratitis Herpes simplex virus infection of the cornea has a series of clinical manifestations, which often lead to repeated corneal inflammation, angiogenesis, scarring and vision loss. Dendritic keratitis symptoms and signs The primary (primary) infection is usually a non-characteristic self-limited conjunctivitis, which can be accompanied by vesicular blepharitis. When relapsed (secondary), usually epithelial keratitis (also It is called dendritic keratitis), which is characterized by a dendritic lesion of the corneal epithelium, similar to the veins of leaves, and a spherical end. Early symptoms are foreign body sensation, tearing, photophobia, and conjunctival congestion. With repeated relapses, corneal sensation diminishes or disappears, which may cause corneal ulcers and permanent corneal scarring. Disc keratitis involves the corneal stroma. It is a discoid localized edema and turbidity deep in the cornea, accompanied by iris, and often occurs after epithelial keratitis. Disc keratitis may represent the body's immune response to the virus. Non-healing or very slow healing epithelial defects caused by repeated herpes simplex virus are called painless ulcers. Local treatment of dendritic keratitis (such as 1% Fluorosine Eye Drops, 9 times a day or 3% Adenosine Arabinoside Eye Cream, 5 times a day) is often effective. Occasionally, acyclovir 400 mg was taken 5 times a day. If the epithelium is loose and edema around the dendritic lesions, light swabbing with a cotton swab tip for debridement can accelerate healing before starting medication. Epithelial keratitis is a local ban on corticosteroids, but when the corneal stroma (disc keratitis) or uveal membrane is tired in the later stage, the combined application of corticosteroids and antivirals may be effective. In cases with uveitis, 1% atropine eye drops are beneficial. Patients who have not recovered after 1 week and those involving corneal stroma or uveal membrane should be treated with an ophthalmologist. Herpes zoster ophthalmicus can be combined with eyelid, conjunctivitis, keratitis, scleritis, uveitis, retinopathy (acute retinal necrosis), optic neuritis, and ophthalmoplegia. 60% of them can develop herpes zoster keratitis, which causes corneal scars and severely affects vision. There is a growing tendency these days and it is worth vigilant.

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