Brănișteanu Daniel Constantin MD, PhD
University of Medicine and Pharmacy “Grigore T. Popa” Iasi
Ocular manifestations of viral skin diseases
Authors: Daniel Constantin Brănişteanu, Cătălina Ioana Brănişteanu, Andrei Bîlha
Many viral pathogens are responsible for both skin and ocular involvement.
Ocular herpes. Eye herpes, also known as ocular herpes, is still a leading cause of blindness in underdeveloped countries. The most frequent ocular manifestation (80%) of herpes simplex virus (HSV) infection is the superficial keratitis. Patients with herpes simplex keratitis have a red, painful eye with decreased vision, photophobia and tearing. Slit lamp examination reveals typical dendritic or punctate corneal ulcerations better seen on Bengal rose or fluorescein test. The corneal sensitivity is decreased.
Herpes Zoster Ophthalmicus. The clinical features of herpes zoster ophthalmicus include dermatomal forehead rash and painful inflammation. The Hutchinson sign (vesicles appearance on the tip or on the side of the nose) predicts the corneal involvement by the ophthalmic herpes zoster.
Ocular Human Papillomavirus Infections. Most frequently ocular involvement is represented by conjunctival squamous papilloma. Ocular surface squamous neoplasia, a spectrum of lesions of the cornea and conjunctiva derived from squamous epithelium, ranging from low-grade dysplasia to invasive squamous carcinoma, might also be related to HPV infection.
Viral Conjunctivitis. Is most frequently related to adenovirus infection, and the main ocular symptoms include moderate to severe conjunctival hyperemia, itching and excessive tearing. Decreased vision and photophobia are the consequence of corneal involvement (Adenoviral Keratoconjunctivitis). Adenoviral corneal opacities can impact visual acuity on medium or long term and also allow a retrospective diagnosis. An associated skin rash can be seen in immunocompromised persons.
Molluscum contagiosum. Often is responsible for nodular, typical lesions on the eyelids that spontaneously disappear within 6-18 months. Chronic follicular conjunctivitis reflects the antigenic reactions induced by the presence of viral protein into tears.
Fig1. Recurrent herpes simplex keratitis on corneal graft