Abstract
Purpose: :
To investigate current management of anterior herpes simplex virus (HSV) eye disease among corneal specialists, and compare these practice patterns to findings published by the Herpetic Eye Disease Study (HEDS) Group.
Methods: :
All members of the Cornea Society listserv were sent the link to an anonymous, web-based survey regarding management of anterior HSV disease.
Results: :
Of the 49 respondents, 92% had completed a cornea fellowship, and 70% were employed in private practice. For initial management of HSV epithelial keratitis, 82% of respondents use topical antivirals and 65% also use oral antivirals; the HEDS demonstrated that the addition of oral acyclovir to topical antiviral therapy was not associated with decreased progression to stromal disease. For stromal and disciform keratitis, and iridocyclitis, most survey respondents used both oral antiviral and topical corticosteroid medications; the HEDS Group recommended topical steroid and topical antiviral as the preferred treatment for HSV stromal keratitis. Only 19% of the survey respondents recommend antiviral prophylaxis to prevent recurrent disease after a single episode of HSV keratitis; the HEDS demonstrated that long-term prophylaxis with oral acyclovir was associated with a decreased risk of recurrent HSV stromal keratitis.
Conclusions: :
This study identified substantial differences between current practice patterns in the management of anterior HSV eye disease compared to HEDS Group findings. Further study is warranted to determine the reasons for these differences.
Keywords: herpes simplex virus • anterior segment