Clinical and Epidemiological Profile of Herpetic Eye Disease in a Tertiary eye Care Center

Abstract

Introduction: Herpes simplex virus (HSV) is the most common infective cause of blindness in developed countries, with a reported incidence of between 5.9 and 20.7 episodes per 100,000 persons each year. It remains the most common cause of unilateral corneal blindness worldwide. HSV ocular infections include conjunctivitis, blepharitis, epithelial infections like dendritic ulcer, geographic ulcer and punctate epithelial keratitis, stromal infections like disciform and necrotizing stromal keratitis, and iritis. Visual loss usually occurs from the cumulative effect of multiple recurrences.

Methodology: Hospital based prospective study was conducted for a period of one year (1st Jan 2015- 31st Dec 2015) at B.P.koirala Lions Center for Ophthalmic Studies, IOM, Kathmandu, Nepal. All patients. with symptoms and signs suggestive of herpes eye disease having decreased comeal sensation were included. Performa included demographic profile of patients, clinical pattern, presenting symptoms, visual acuity on presentation and treatment received.

Results: Incidence of Herpetic Eye Disease was 10.3%. Patients presented with mean age of 36.63 ± 16.94years.59.23% patients presented in productive young adult age group of 16-45 years.Patients presented with chief complain of redness 38%, Diminution of vision 33%, Pain 12%, foreign body sensation 13% and photophobia in (4%) of cases. Clinical pattern was Blepheroconjunctivitis in 26%. Filamentary keratitis in 1%, dendritic ulcer in 22%, Geographical ulcer in 4%, disciform keratitis in 28%, Stromal keratitis in 11% and recurrent keratitis in 3% cases. Treatment received included topical Acyclovir in 54% cases, oral Acyclovir and topical steroids in 43% cases and topical, oral acyclovir with topical steroids in 3%cases. Visual acuity on presentation was 6/6-6/18 in 59.23% of patients and only 8.47%cases had visual acuity >3/60.

Conclusion: Herpetic eye disease is a corneal blinding disease with varying clinical presentation. The recurrence rate was low in our study. But, recurrent nature of this disease and the treatment required to decrease this recurrence needs to be further studied