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A tear film aspirate, from the lower fornix of a 64-year-old man with the clinical diagnosis of a herpes simplex indolent corneal ulcer, was examined via a new, rapid immunoperoxidase staining technique. This 4-hour modified immunoperoxidase stain is both sensitive and specific for herpes simplex virus type 1. The corneal epithelial cells shed in the tear film from the indolent ulcer were strongly positive for herpes simplex type 1 viral antigen using this new technique. This case report supports the theory that the pathogenesis of indolent herpetic corneal ulcers involves both a hypersensitivity response to viral antigen and an active viral infection.

The following is a case report of a 61-year-old woman with a 10-year history of pemphigus vulgaris, successfully treated with steroids and cytotoxic agents. The patient developed severe herpes zoster ophthalmicus, complicated by a staph-indolent corneal ulcer. This case illustrates several of the many unfortunate ophthalmological complications that may develop in the immunocompromised patient.