The Herpetic Eye Disease Study

There are an estimated 500 000 episodes of eye disease with herpes simplex virus in the United States each year, and herpetic infections of the eye are a major cause of corneal opacity and visual loss. 1 There is still considerable controversy, even among knowledgeable ophthalmologists, on the optimal management of herpetic eye disease. While topical antivirals, such as trifluridine, are effective in treating herpetic ulceration of the corneal epithelium, these drugs do not control disease in the deeper structures of the eye. Herpetic stromal keratitis and iridocyclitis are often treated with corticosteroids to suppress the inflammatory response. Local steroids, however, enhance recurrences of infectious herpetic epithelial keratitis and are implicated in prolonging the course of the disease, increasing its severity, and predisposing to secondary complications, such as corneal perforation. 2-8 The development of the potent, specific, antiviral acyclovir, particularly the oral form, has dramatically changed the clinical approach to