Treatment of viral diseases of the cornea and external eye

Ocular virus infections remain an important cause of corneal and external d isease. Herpes simplex. the most important, is easily treated when ii is co nfined to the epithelium. New studies indicate that herpetic stromal diseas e and iritis are effectively treated with a combination of corticosteroid a nd antiviral without additional risk. Recurrences of ocular herpetic diseas e can be reduced with acyclovir given orally; the benefit seems to be great est in patients who have had at feast one episode of stromal keratitis. Her pes tester can be treated with either acyclovir or famciclovir, but to be e ffective, treatment must be initiated within 72 hours of onset. Early treat ment reduces the risk of post-herpetic neuralgia and may reduce the risk of ocular complications. Adenovirus infection (epidemic keratoconjunctivitis) is often spread by the ophthalmologist. New medications such as cidofovir appear to be effective against the adenoviruses in non-human systems and ma y have some effect in man, although previously, drugs that appeared to have an effect in vitro have proven to be ineffective in the clinical setting. (C) 1999 Elsevier Science Ltd. All rights reserved.