Tetracaine provides better conjunctival anesthesia than proparacaine hydrochloride; however, it has antimicrobial properties that may interfere with organism recovery when cultures are performed.
Most organisms are eventually cleared from the site of an acute infection, but some persist in the host indefinitely. For example, after primary infection, herpes simplex virus and varicella-zoster virus establish latency in trigeminal ganglion cells.
Topical antivirals for herpes simplex keratitis are rarely needed for longer than 7–10 days. Persistent disease despite topical antiviral therapy suggests misdiagnosis, medication toxicity, or immune dysfunction.
Excerpted from BCSC 2020-2021 series: Section 10 - Glaucoma. For more information and to purchase the entire series, please visit https://www.aao.org/bcsc.