Knowing the risk factors for HSV keratitis can reduce its occurrence

Almost everyone is at some risk for herpes simplex virus (HSV) keratitis, although there are several risk factors that need to be kept in mind and prophylaxis in those cases can reduce the risk of recurrence by around 50 per cent , said Marc Labetoulle MD, Paris, France, at the ESCRS/EuCornea Cornea Day during the 19th ESCRS Meeting in Istanbul. Dr Labetoulle noted that some studies suggest that antibodies to the virus are present in up to 90 percent of people by the age of 50 years. The lifetime risk of herpes simplex keratitis is 0.23 per cent by 30 years and 0.49 per cent by 50 years. The disease occurs in about 150/100,000 of the general population. In around a third of cases there are triggering factors involved. They include stress and fatigue, infectious diseases, ultraviolet radiation and ocular surgery.HSV keratitis accounts for about 10 percent of graft indications and for about a third of graft failures, Dr Labetoulle said. Therefore, prevention of herpes simplex keratitis is mandatory in eyes of patients with a history of HSV undergoing keratoplasty procedures. Acyclovir 400 mg twice daily reduces the recurrence rate by half.