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■ Herpes simplex keratitis (HSK), a result of infection predominantly with the Herpes Simplex Virus-1 (HSV-1) virus, is the most common infectious cause of unilateral blindness and one of the commonest indications for a penetrating keratoplasty ■ The virus may reach the eye by one of two main routes: the "back door" route, that is, entry via the mouth with subsequent spread to the eye; or the "front door" route with direct entry onto the ocular surface with subsequent recurrence in the cornea ■ Anterior segment disease caused by HSV-1 can affect all levels of the cornea, and also cause uveitis and iridocorneal endothelial syndrome ■ Primary disease is usually asymptomatic and recurrent disease usually affects vision through scarring, thinning, and neovascularization. The outcome of infection depends on a number of factors, including viral genes encoded by each strain and the genetic make-up of the host and host immune system ■ Recurrent corneal disease may be a result of anterograde axonal spread from the trigeminal ganglion, persistent or reactivated virus within the cornea. Usually, this is the result of re-activation of the initial strain, but super-infection with a new strain is also possible ■ A combination of polymer chain reaction (PCR) and immunohistochemistry (IHC) offers high specificity and sensitivity for both active disease and diagnosis of corneal scars ■ Topical antivirals are usually sufficient in epithelial disease. Treatment of stromal disease responds to initial topical antivirals followed by a combination of topical antivirals and steroids. Adequate levels of antivirals can be achieved in the anterior chamber following systemic administration in herpetic uveitis ■ Orally administered systemic aciclovir reduces the recurrence of herpetic keratitis and keratouveitis ■ Keratoplasty (penetrating, lamellar, and deep lamellar) is an effective treatment for HSV-1-induced corneal scarring, but rejection and recurrent HSK remain a cause for concern. Antiviral prophylaxis, however, leads to a significant reduction in post-transplant recurrence [ABSTRACT FROM AUTHOR]