HSV Blepharitis

• May present as a primary or recurrent disease

Clinical Features

• Symptoms:
  • Asymptomatic
  • May present with prodromal systemic symptoms such as fever, malaise, myalgias and regional adenopathy
  • Signs:
    • Primary infection:
      • Usually resolves over 2-3 week and heals without scarring
      • Becomes clinically overt in 3-9 days with manifestation of periocular clustered vesicular eruption, conjunctivitis, keratitis or preauricular adenopathy
      • The lesions usually confine to periocular region
      • Recurrent infection
        • Usually is a shorter course of disease
        • Focal clusters of vesicles or ulcerations along the lid margin may develop in 2-3 days and last for only 5 to 7 days
        • Diagnosis is made clinically

Management

• Prophylactic antiviral ointment or drops is indicated to protect the globe
• Aggressive treatment is required in the presence of corneal involvement because it may cause permanent corneal scarring and visual disturbance