DR. JYOTI DESWAL

DR. JOGINDER PAL CHUGH, DR. RAJENDRA SINGH CHAUHAN, DR. ASHOK RATHI

Abstract

A 14year old girl presented with gradual painful diminution of vision in both eyes for the past 1 week associated with redness and watering. BCVA R/E was FC4mt and in L/E6/24. B/E circumcorneal congestion was present with follicles seen along the temporal limbus and multiple patchy stromal infiltrates were present with diffuse corneal haze (R>L). In left eye, there was a small descematocele at 12 o’clock position. The diagnosis of Herpetic Necrotising Keratitis was made and the patient was started on oral acyclovir and topical fortified antiobiotics and cycloplegics . Within 2 weeks, the stromal edema and infiltrates got cleared leaving behind a opacity in L/E. At 1 month, the patient had BCVA 6/6(P) in both eyes. Necrotising keratitis due to herpes simplex virus mimicks bacterial or fungal keratitis and can lead to corneal perforation if left untreated. Timely diagnosis and management of the same can prevent need for penetrating keratoplasty and improves quality of life of patient.