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Case Series

Pediatric Herpes Simplex Keratitis

Bodack, Marie I., OD, FAAO1*

doi: 10.1097/OPX.0000000000001345

SIGNIFICANCE Although the clinical appearance of pediatric ocular herpes simplex virus (HSV) is similar in children and adults, there is evidence that stromal disease and recurrences are more common in pediatric patients. Misdiagnosis of these patients is common, and patients can develop corneal scarring and amblyopia.

PURPOSE This case series will review important clinical concepts on pediatric ocular HSV including differences in presentation and current treatment recommendations.

CASE REPORTS Three pediatric patients with HSV keratitis are presented: a 6-year-old girl who was treated for unilateral disease over the course of 3 years, a 7-year-old boy who presented with bilateral disease, and a 3-year-old girl in whom the diagnosis was not apparent initially. All patients were successfully treated with oral acyclovir and topical steroids. One patient was also treated with topical antivirals.

CONCLUSIONS Pediatric HSV keratitis should be considered as a differential diagnosis in pediatric patients who present with keratitis. Accurate diagnosis of these patients is important so that amblyopia does not develop. Pediatric ocular HSV patients can be successfully treated with topical and/or oral medications, although their treatment duration may be 12 months or longer.

1Southern College of Optometry, Memphis, Tennessee *

Submitted: February 6, 2018

Accepted: October 4, 2018

Funding/Support: The author has reported no funding/support.

Conflict of Interest Disclosure: No conflict of interest.

Author Contributions and Acknowledgments: Writing – Original Draft: MIB.

Thanks to Dr. Alan Kabat for permission to use the OVS Announces synopsis image and Dr. Emily Shull for the images used for Figures 1 and 2.

© 2019 American Academy of Optometry