Herpes simplex keratitis

Author: Nat Pernick, M.D. (see Authors page)

Revised: 1 May 2018, last major update October 2013

Copyright: (c) 2004-2018, PathologyOutlines.com, Inc.

PubMed Search: Herpes simplex keratitis [title] pathology

Cite this page: Pernick, N. Cornea: herpes simplex keratitis. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/eyecorneaHSVkeratitis.html. Accessed December 13th, 2018.
Definition / general
  • Most common cause of corneal ulcers
  • Usually unilateral, may recur
  • Usually HSV1
  • Difficult in recurrent cases
  • May need EM, PCR, ISH or immunohistochemistry since cultures are usually negative and inclusions are rarely identified
Microscopic (histologic) description
  • Diffuse epithelial edema causing bullae between epithelium and Bowman layer
  • Also patchy loss of Bowman layer
  • Irregular epithelium
  • Infiltration of anterior stroma by lymphocytes and plasma cells with stromal fibrosis and neovascularization
  • Severe cases have granulomatous reaction surrounding Descemet membrane
  • Herpetic inclusions are rare