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    Taking on surgery in HSV patients

    Surgeons weigh best candidates, benefits against risks of stimulating recurrence of herpes simplex virus

     

    HSV keratitis

    If HSV keratitis occurs after ocular surgery, treatment depends on whether the infection is caused by the live virus, an immune-mediated reaction, or a metaherpetic process, Dr. Yeu said.

    She recommended maintaining enough topical steroids to facilitate recovery from the surgery, but to mitigate topical steroids in the setting of epithelial keratitis.

    The active live virus can cause dendrites or geographic ulcers of the epithelium, necrotizing keratitis in the stroma, and keratouveitis in the anterior chamber. Immune-mediated HSV keratitis includes non-necrotizing stromal keratitis, disciform or linear endotheliitis, and possibly keratouveitis, she said.

    Non-necrotizing HSV stromal keratitis is associated with the highest and most severe ocular morbidity, Dr. Yeu said, and can include stromal edema, vascularization or lipid deposition with the epithelium intact, and an antibody-complement cascade against retrained viral antigens in the stroma.

    All endotheliitis should be treated with aggressive topical steroids, she said.

    The disciform is the most common form. It is immune-mediated and can be recognized by its disc-shaped area of edema and keratic precipitates, Dr. Yeu added.

    The diffuse form, which is also immune-mediated, is characterized by dense retrocorneal plaque. Linear endotheliitis, on the other hand, may be a sign of a live virus.

    Metaherpetic disease

    A metaherpetic keratitis process, such as a neurotrophic ulcer or drug toxicity, should be considered where the cornea fails to re-epithelialize after 14 to 21 days of treatment, Dr. Yeu said.

    “Metaherpetic means something transitional,” she explained. “You know something else going on.

    “It could be neurotrophic,” she said. “It could be that the nerves are so damaged from prior HSV infections that the cornea itself doesn’t sense that something is wrong so it doesn’t trigger the processes in order to heal that wound. Or it could be treatments that are too toxic for it.”

    Trifluridine, which was considered a treatment of choice prior to topical gancyclovir, “is extremely toxic and was a common culprit for a poorly healing corneal epithelium,” Dr. Yeu said. A secondary infection could be another reason for metaherpetic keratitis.

    Signs of neurotrophic keratopathy include confinement within the interpalpebral fissure; epithelization that has been delayed for more than 2 to 3 weeks; poor sensation; and oval, rolled edges with smooth borders.

    HSV ulcer

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    • Anonymous
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    • [email protected]
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    • [email protected]
      NATURAL HERBS REMEDY CURE HSV TYPE 2. I am from USA i was diagnosed with Hsv type 2 while I was pregnant .I cried for days. I was devastated and looking up info on it just made it worse. I don't know how long I have had it for. I don't know if my partner has it or if he was the one who transferred it to me. I had one outbreak while pregnant. That's how I found out I had the virus. I started taking and antiviral and took it everyday twice a day to make sure I wasn't able to get an outbreak. I debated whether I wanted to have my daughter natural or c- section. I was terrified. Stress wasn't helping my situation. I ended up having her natural and she is a beautiful healthy 2 month old baby girl. I try not to think about me having the virus because of my depression i couldn't. so I have to focus more on how to get rid of Hsv type 2 because i don't want anything to happen to my daughter and thank God she was born fine. i visited different hospital but they gave me list of drugs like acyclovir, Zovirax, and (valacyclovir)Valtrex without without get rid of my virus. one day i decide to surf the internet for cure so i saw a testimony total cure of herpes by Dr. Osemu with natural herbs so i pick up the email Address: [email protected] and contact he an hour later he reply explain to me how am going to get the herbs and how am going to use it to cure my virus i give a try believe me it work perfectly i used it within seven days now am tested negative i am free from the virus thanks Doc. for so many passing through this contact Dr. Osemu to help you get rid of the virus. here is his email address: [email protected] you can also add him on whats app +2348162084504 He can as well cure so many diseases like........... 1. ALS 2. HPV 3. CANCER 4. HIV/AIDS 5. BREAST ENLARGEMENT
    • [email protected]
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    • [email protected]
      Hello everyone!! I was diagnosed of Genital Herpes Simplex Virus (HSV) in 2015 and I have tried all possible means to get cured, i even visited Some Hospital where they gave me some drugs like Famvir, Zovirax and Valtrex which are very expensive but all to no avail, until i saw a post in a health forum about a herbal doctor from West Africa who prepare herbal medicine to cure all kind of diseases including Herpes Simplex Virus, at first i doubted if it was real but decided to give it a try, when i contact this herbal doctor via his email he sent me a herbal medicine through courier service, when i received this herbal medicine, he gave me step by instructions on how to apply it, when i applied it as instructed i was totally cured of this deadly disease within 12-14 days of usage, if you are suffering of this diseases you can as well Contact this great herbal doctor via his email; [email protected] or whatsapp no:+2348159921615

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