Herpes Simplex Virus-Associated Anterior Uveitis: Clinical Characteristics, Diagnosis, and Current Aspects on Management

Abstract

Herpes simplex virus (HSV)-associated anterior uveitis accounts for 5–10% of patients with anterior uveitis and 3–10% of all uveitis patients, and is the most frequent etiology of infectious anterior uveitis. It is chiefly an acute unilateral iritis involving middle-aged individuals with preponderance in females. The clinical features of HSV anterior uveitis may mimic other non-infectious and infectious anterior uveitis entities, particularly at the early stage of the disease. Confirmed prior HSV infection and the presence of characteristic ocular findings such as keratitis, high intraocular pressure, and sectoral or patchy iris atrophy suggest the diagnosis and help to differentiate this condition from other etiologies of anterior uveitis. New diagnostic techniques, including evaluation of intraocular fluids applying polymerase chain reaction for viral DNA and the Goldmann–Witmer coefficient for antibodies against the virus can confirm the diagnosis in cases with no specific signs of HSV anterior uveitis. Oral antivirals and topical corticosteroids have become the main standards for treatment.