Glickman Amanda, Hunter Amanda, Greenberg Paul B, Galler Ezra, Mega Joseph, Sellechio John
Eye Clinic, Providence Veterans Affairs Medical Center, Rhode Island.
New England College of Optometry, Boston, Massachusetts.
Fed Pract. 2022 Oct;39(10):403-405. doi: 10.12788/fp.0323. Epub 2022 Oct 14.
Herpes simplex keratitis (HSK) is a common yet potentially blinding condition caused by a primary or reactivated herpetic infection of the cornea. Immune stromal keratitis (ISK), a type of HSK, is classified by a cellular and neovascularization infiltration of the cornea, and patients with ISK may experience low-grade chronic keratitis for years.
A 52-year-old man presented to the eye clinic complaining of a watery and itchy right eye with mildly blurred vision. With consultation from a corneal specialist, the patient was given the presumptive diagnosis of ISK in the right eye based on the unilateral corneal presentation and lack of corneal sensitivity.
ISK presents unilaterally with decreased or absent corneal sensitivity and nonspecific symptoms. It should be at the top of the list in the differential diagnosis in any patient with unilateral corneal edema, opacification, or neovascularization, and the patient should be started on oral antiviral therapy.
单纯疱疹性角膜炎（HSK）是一种常见但可能致盲的疾病，由角膜原发性或再激活的疱疹感染引起。免疫性基质性角膜炎（ISK）是HSK的一种类型，其特征为角膜的细胞浸润和新生血管形成，ISK患者可能会经历数年的轻度慢性角膜炎。
一名52岁男性到眼科门诊就诊，主诉右眼流泪、瘙痒，视力轻度模糊。经角膜专科医生会诊，根据单侧角膜表现及角膜感觉减退，该患者被初步诊断为右眼ISK。
ISK表现为单侧角膜感觉减退或消失，并伴有非特异性症状。对于任何单侧角膜水肿、混浊或新生血管形成的患者，在鉴别诊断中应首先考虑该病，且应开始给予患者口服抗病毒治疗。
