Ophthalmology · UKMLA & AKT
Herpes simplex keratitis
A free high-yield preview for the UKMLA Applied Knowledge Test. Below are the key points to recognise herpes simplex keratitis — the full SA Note notes add investigations, management, complications and 10 practice questions.
Key high-yield points
- Almost always unilateral; young/middle-aged adults
- Painful red eye - circumcorneal (limbal) injection
- Foreign body sensation - can mimic corneal abrasion or foreign body
- Photophobia - due to corneal nerve irritation
- Watery (clear) discharge - distinguishes from bacterial keratitis (purulent)
- Periocular vesicles or crusted lesions on eyelid margin/surrounding skin
- Palpable preauricular lymph node - classic sign of viral aetiology
The dendritic ulcer (branching/tree-like pattern on fluorescein staining) is pathognomonic of HSV epithelial keratitis - its pattern reflects viral spread along corneal epithelial nerve endings.
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