Aciclovir eye ointment 3% five times/day or ganciclovir 0.15%, five times daily for 7 days, and then three times daily for a further 7 days is recommended for dendritic ulcers. Treatment is controversial as it is often self-limiting, but topical and systemic antivirals have been used. The virus can present with cold sores or fever blisters (vesicular dermatitis – see Figure 1), follicular blepharo-conjunctivitis, superficial punctate keratitis (SPKs) and/or dendritic ulcer. Primary ocular herpes infection is often asymptomatic. After the initial infection, the virus can enter nerve cells in the dorsal ganglia and lie dormant, or latent. Herpes simplex virus is usually acquired in childhood or adolescence. It causes genital herpes infections and, occasionally, ocular neonatal infection.
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