Herpes simplex virus keratitis: an update of the pathogenesis and current treatment with oral and topical antiviral agents

Clin Exp Ophthalmol. 2016 Dec;44(9):824-837. doi: 10.1111/ceo.12785. Epub 2016 Jul 26.


Ophthalmic herpes simplex viral keratitis is responsible for a range of ocular manifestations from superficial epithelial disease to stromal keratitis and endotheliitis. The Herpetic Eye Disease Study has guided the management of herpetic eye disease for almost twenty years, but newer medications such as valacyclovir are now available and are considered to have better bioavailability than acyclovir. In this review, we examine the existing evidence on the pathogenesis of different ophthalmic herpes simplex viral keratitis disease modalities and the role of oral and topically administered antiviral drugs in the treatment of herpes simplex viral keratitis.

Keywords: acyclovir; ganciclovir; herpes simplex keratitis; valacyclovir.

Publication types

  • Review

MeSH terms

  • Acyclovir / analogs & derivatives
  • Acyclovir / therapeutic use
  • Administration, Oral
  • Administration, Topical
  • Antiviral Agents / therapeutic use*
  • Debridement
  • Herpesvirus 1, Human / physiology
  • Humans
  • Keratitis, Herpetic / drug therapy*
  • Keratitis, Herpetic / etiology*
  • Valacyclovir
  • Valine / analogs & derivatives
  • Valine / therapeutic use


  • Antiviral Agents
  • Valine
  • Valacyclovir
  • Acyclovir