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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 ulcer

    If an HSV ulcer persists for more than 2 weeks, Dr. Yeu recommends stopping topical anti-viral treatment and changing to an oral anti-viral prophylaxis, aggressive preservative-free lubrication, a therapeutic bandage over the lens (with particular caution on a neurotrophic ulcer), topical anti-bacterial coverage, self-retaining amniotic membrane, and vitamin C, omega-3 fatty acids, and doxycycline.

    Treatments for keratitis caused by the live virus include valcyclovir 500 to 1,000 mg po TID, acyclovir 400 mg po 5× daily, acyclovir 0.3% ointment 5× daily (not available in the United States), ganciclovir 0.15% gel 5× daily, and trifuridine 1% every 2 hours (with caution because of toxicity), with a potential concomitant epithelial debridement to debulk the viral load.

    HSV epithelial keratitis is a self-limited disease, but treating it as a live viral infection for 21 days can help expedite recovery and limit nerve damage or future immunological disease, Dr. Yeu said.

    For keratitis caused by an immune-mediated reaction, antiviral prophylaxis should be instituted at the lower prophylaxis protocol as aforementioned to prevent re-activation of the active virus from the topical steroid use, according to Dr. Yeu.

    Topical steroids with a very slow taper over months should be used to treat the inflammation, and may be needed once or twice a week indefinitely to maintain remission. Common high-dose topical steroids are needed, such as topical difluprednate 0.05% or prednisolone 1%, every 2 to 3 hours with a very slow taper down to weaker steroids and less frequency.

     

    Elizabeth Yeu, MD

    P: 757/622-2200     E: [email protected]

    This article was adapted from Dr. Yeu’s presentation during Cornea Day at the 2017 meeting of the American Society of Cataract and Refractive Surgery. Dr. Yeu is a consultant or advisor to Alcon Laboratories, Allergan, ArcScan, Bausch + Lomb/Valeant, BioTissue, iOptics, Johnson & Johnson Vision, LENSAR, Kala Pharmaceuticals, Ocular Science, Ocular Therapeutix, Omeros, Ocusoft, Shire, SightLife Sun, Surgical, TearLab Corp., and TearScience. Her research has been sponsored by Alcon, Allergan, iOptics, Kala, and Topcon. She has ownership interest in ArcScan, Modernizing Medicine, Ocular Science, RPS, SightLife Surgical, and Strathspey Crown.

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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]
      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]
      Any body reading this testimony now should help me to rejoice and thank dr tokubo for curing me completely from herpes virus . I was told i have herpes in 2015, i have been taking different kinds of medication still yet no improvement until i saw testimonies of a woman who dr tokubo helped to cure herpes. I was skeptical about contacting him but i also knew the importance of herbal medicine because i have heard about it before that i work perfectly, i made up my mind and contacted him we talked on phone and he prepared the herbs medicine and send the medicine to me through DHL delivery services which i took according to his dosage information. Now I’m so happy I’m cured from Herpes my heart is so filled with joy because my herpes test came out negative, thank you so much Dr Tokubo. If you are reading this and you have Herpes or any kind of disease contact him +2349037990322 or email him at [email protected]

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