Commentary: Diagnostic markers for suspected herpes simplex virus keratitis – A bridge too far

Abstract

One of the common indications for optical penetrating keratoplasty (PK) in India is a postinfectious corneal scar. The primary infection can be due to bacteria, fungi, protozoa, or viruses like the herpes simplex virus type-1 (HSV-1). While a healed bacterial or fungal keratitis does not bear any future consequences on the graft, HSV-1 keratitis can recur after PK. Such recurrences in many instances may lead to graft opacity. Although recurrences can be mitigated with the use of oral acyclovir,[1] the surgeon has to either confirm or strongly suspect a viral etiology to advise acyclovir prophylaxis. In most cases, it is not possible to infer the causative organism from the morphological appearance of the scar.