Herpes simplex Conjunctivitis

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Clinical Features

  • Blepharoconjunctivitis is typical in primary herpes simplex virus (HSV) infection
  • Follicular conjunctivitis with swollen preauricular lymph nodes
  • Vesicles on the eyelid margin or eyelids
  • Epithelial keratitis possible
    • Stromal keratitis and uveitis are rare
  • Differential diagnosis: Adenovirus keratoconjunctivitis
    • HSV
      • Vesicles on the eyelid margin or eyelids
      • Ulcerations on the eyelid margin or bulbar conjunctiva
      • Dendritic keratitis
      • Can be bilateral
    • Adenovirus
      • (Pseudo)membranes
      • Bilateral presentation


  • Virgan gel 5x/d until healing
  • alternatively Zovirax ointment 5x/d


  • typically after 2 – 3 days to assess response to therapy


  • EyeWiki Conjunctivitis
  • Basic and Clinical Science Course 2017-2018, Section 8 External Disease and Cornea, American Academy of Ophthalmology (AAO)
  • The Wills Eye Manual: Office and Emergency Room Diagnosis and Treatment of Eye Disease; Nika Bagheri MD, Brynn Wajda MD, et al; Lippincott Williams&Wilkins; 7th Edition (2016)
  • Kanski’s Clinical Ophthalmology: A Systematic Approach; John E Salmon MD; Elsevier; 9th Edition (2019)