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Herpes Simplex Virus (HSV) Conjunctivitis
Î Topical and/or oral antiviral treatment is recommended for HSV
conjunctivitis to prevent corneal infection. (I++, G, S)
Î Topical antiviral agents may cause toxicity if used for more than 2
weeks. (III, I, D)
Î Topical corticosteroids potentiate HSV infection and should be
avoided. (III, I, D)
Î Within 1 week of treatment, patients should have a follow-up visit
consisting of an interval history, visual acuity measurement, and slit-
lamp biomicroscopy. (III, I, D)
Î Neonates require prompt consultation with the pediatrician or primary
care physician, because systemic HSV infection is a life-threatening
condition. (III, I, D)
Varicella (Herpes) Zoster Virus (VZV) Conjunctivitis
Î Many clinicians treat VZV conjunctivitis patients with topical
antibiotics to prevent secondary infection, since the vesicles will
undergo necrosis before healing. (III, I, D)
Î Topical antivirals have not been shown to be helpful in treating VZV
conjunctivitis. (III, I, D)
Î When treatment seems justified for the immunocompetent patient,
oral antivirals are recommended at a dose of 800 mg five times
daily for 7 days for acyclovir, 1000 mg every 8 hours for 7 days for
valacyclovir, or 500 mg three times daily for 7 days for famciclovir.
(III, I, D)
Î Immunocompromised patients may need to be treated more
aggressively. (III, I, D)
Î Caution is advised in patients with impaired renal clearance. (III, I, D)
Molluscum Contagiosum
Î Treatment to remove the lesions is indicated in symptomatic
molluscum contagiosum patients. (III, I, D)
Î Treatment options include incision and curettage, simple excision,
excision and cautery, and cryotherapy. (III, I, D)
Î Follow-up is not usually necessary unless the conjunctivitis persists.
(III, I, D)
