From the Guidelines
Herpetic conjunctivitis should be treated with topical antiviral medications, such as ganciclovir 0.15% gel used three to five times per day, and oral antivirals like acyclovir (200 to 400 mg five times a day) for 7-10 days, as this approach has been shown to be effective in managing the condition while minimizing the risk of complications. The treatment of herpetic conjunctivitis involves a combination of topical and oral antiviral medications, with the goal of reducing the severity and duration of symptoms, as well as preventing complications like corneal scarring or vision loss 1. Some key points to consider in the management of herpetic conjunctivitis include:
- Topical trifluridine 1% solution can be used five to eight times per day, but it may cause epithelial toxicity if used for more than 2 weeks 1
- Topical ganciclovir is less toxic to the ocular surface and can be used as an alternative to trifluridine 1
- Oral antivirals like valacyclovir (500 mg two or three times a day) or famciclovir (250 mg twice a day) can be used in addition to topical treatment for more severe cases 1
- Topical corticosteroids should be avoided as they can potentiate HSV epithelial infections 1
- Patients should be followed up within 1 week of treatment to assess the response to therapy and to rule out any complications 1.
From the Research
Herpetic Conjunctivitis Treatment
- Herpetic conjunctivitis is caused by the herpes simplex virus (HSV) and can lead to corneal blindness 2.
- Several antiviral agents are available for the treatment of herpetic conjunctivitis, including trifluridine, vidarabine, acyclovir, and ganciclovir 3, 4, 2.
- Trifluridine has been shown to be effective in treating herpetic keratitis, with a success rate of over 90% in patients with dendritic ulcers 3.
- Ganciclovir is a potent inhibitor of members of the herpes virus family and has been shown to be safe and effective in the treatment of herpetic epithelial keratitis 2.
- Topical antiviral therapy, such as trifluridine or ganciclovir, can be effective in treating herpetic conjunctivitis, even in cases where oral antiviral therapy has failed 5.
Antiviral Agents
- Trifluridine is an antiviral agent that is structurally related to idoxuridine and has been shown to be effective in treating herpetic keratitis 3.
- Acyclovir is an antiviral agent that is commonly used to treat herpesvirus infections, including herpetic conjunctivitis 4, 6.
- Ganciclovir is an antiviral agent that is potent inhibitor of members of the herpes virus family and has been shown to be safe and effective in the treatment of herpetic epithelial keratitis 2.
- Cidofovir has been used successfully to treat some cases of adenoviral conjunctivitis, although toxicity has also been reported 6.
Treatment Outcomes
- Topical antiviral therapy can enable resolution of herpetic epithelial keratitis within 3 to 10 days after initiation of treatment 5.
- Long-term use of ganciclovir ophthalmic gel can prevent recurrences of herpetic keratitis in patients with penetrating keratoplasty 2.
- Antiviral drugs can be effective in treating viral conjunctivitis, although caution should be exercised when coadministering other pharmacological agents, such as corticosteroids, due to emerging adverse effects 6.