Discussion in 'Spot Diagnosis' started by Egyptian Doctor, Feb 18, 2013.
what is your medical diagnosis ?
Dendritic ulcer in the cornea showing up with fluoresceine dye under uv light - Herpetic Corneal Ulcer due to Herpes Simplex virus.
Diagnosis - Herpes Simplex Keratitis
Herpes simplex keratitis.
oral or topical ?
At my institute, we had better success with idoxuridine 0.1 % eyedrops ( 1hourly during day and 2 hourly at night - till healing occurs ) vis a vis acyclovir 3% ointment - 5 times a day till ulcer heals.
Topical - highly doubt we have idoxuridine ED here (we have it with lignocaine in a cold sore topical product); and if its to be applied hourly, then likely the adherence/implementation of will be poor. The other one I've heard of, but again don't use, is foscarnet in this diagnosis
0.5 % idoxuridine eyedrops can be applied every 5 hourly, but the patient has to buy it from outside...and they think that it's their right to avail of the full hospitality of the government services and that we ( the medical team ) r trying to shy away from our responsibilities by offering the 0.5 % option. So i do the reverse ...while awake every 2 hours and while asleep every 45 minutes. Within a day most fetch the 0.5 % drops.
Haven't tried foscarnet eyedrops for this indication...so don't know how it compares.
Answer : Herpes Simplex Keratitis
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