Herpes simplex corneal infection

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Refer all cases of suspected ocular herpes simplex infection to ophthalmology immediately. Do not initiate drug treatment while awaiting specialist ophthalmology assessment.

Antimicrobial recommendations

Ganciclovir 0.15% eye gel: apply 5 times a day until healing complete, then apply 3 times a day for a further 7 days, treatment does not usually exceed 21 days.

• During treatment with ganciclovir eye gel, women of childbearing age should use effective contraception during treatment, and men with partners of childbearing age should be advised to use barrier contraception during and for at least 90 days after treatment.

Consider Aciclovir 200-400mg 5 times daily orally for 7 days. 

Consider Aciclovir oral 400mg twice daily maintenance dose to prevent recurrence.

Notes

See NICE CKS guidance on ocular herpes simplex for further information