Differentiating Herpes Simplex and Varicella Infections

In this interview from AAO 2016, Dr. Bennie H. Jeng offers advice on the diagnosis and management of patients with herpes simplex virus (HSV) and varicella zoster virus (VZV). Both viruses present with distinctive forms of epithelial keratitis, yet stromal disease is often ambiguous. Dr. Jeng stresses the importance of determining which virus is responsible as early as possible so that the appropriate antiviral regimen is administered. Dr. Jeng recommends 400 mg 5x daily, or the lower dose of famciclovir as per the HEDS protocol, for HSV, and doubles these doses for patients with VZV. Long-term suppressive therapy was shown in the HEDS II study to prevent recurrence of HSV, and the NEI has just funded the Zoster Eye Disease Study (ZEDS) to investigate if similar treatment is effective in VZV.