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Very recent studies indicate that a primitive immune system plays an important role in resisting herpesvirus infections in the mouse. This system appears to be reflected by the NK cell assay and preliminary data suggest that this test reflects resistance in man to herpesvirus infections. We propose that ths system may be responsible for resistance to reactivated herpesvirus infections and its suppression might result in clinically apparent disease. Studies in our laboratory are currently aimed at evaluating this possibility.

Three children (6 eyes) with systemic tyrosinemia who presented with a diagnosis of herpes simplex keratitis are described. Two of the patients underwent extensive treatment for herpes simplex keratitis until their defects in tyrosine metabolism were discovered. All three children responded favorably to a low-tyrosine diet. These cases illustrate the typical corneal findings of the Richner-Hanhart syndrome (pseudodendritic keratitis, hyperkeratotic skin lesions of the palms and sole without mental retardation). The findings in these three patients were similar to those cases previously reported in the literature except none had mental retardation. The ophthalmologist confronted with a young child with bilateral dendritiform keratitis should request evaluation of the serum tyrosine levels.

An immunosuppressed recipient of a renal allograft developed bilateral necrotizing retinitis. Disseminated herpes simplex infection was documented by clinical findings and serologic and viral culture studies. Cultures and serologic tests for cytomegalovirus were negative. The evidence strongly favored the diagnosis of herpes simplex retinitis. Tapering of immunosuppressive drugs and administration of adenine arabinoside appeared to halt temporarily the progression of the disease in one eye and resulted in healing of the retinitis in the other eye. Subsequent progression of the more severely involved right eye resulted in an exudative retinal detachment and loss of vision prior to the patient's death from meningoencephalitis. Herpes simplex retinitis must be considered in the differential diagnosis of necrotizing retinitis in an immunosuppressed patient.

Atopic dermatitis is a common skin disease associated with other allergic diatheses. Ocular complications were seen in 85 (42.5%) of 200 patients. Blepharoconjunctivitis, cataracts, corneal disease and ocular herpes simplex were frequent. Cataract surgery was usually successful, but there were complications of such surgery. The rate of success in attempts to wear contact lenses was surprisingly high for both phakic and aphakic patients.

Mycobacterium bovis (BCG, Pasteur strain) was injected intraperitoneally into guinea pigs and rabbits on the 19th and 5th days prior to the intracorneal inoculation of Herpesvirus hominis. During a three-day and nine-day observation period, respectively, the BCG had no significant effect on the clinical course of the herpetic keratitis and no effect on the titer of virus present in the infected corneas.