HERPETIC KERATO-UVEITIC: WHEN INFLAMMATION, EDEMA AND DRYNESS GET COMBINED!

A 45 year old woman, with no pathological history, consulted for an acute pain, redness and decreased vision of the left eye.

The ophthalmologic examination found: Visual acuity 20/20 at the right eye, hand motion at the left eye.Intraocular pressure: 20mmHg right eye, 35mmHg left eye. In the left eye, we found blepharitis, peri keratic circle, conjunctival hyperemia, BUT<10s, corneal hypoesthesia, superficial punctate keratitis, corneal edema with epithelial and subepithelial bubbles of different sizes, mixte diffuse retro-corneal precipitates, crystalline iris synechiae on 360 degree, cellular and proteic tyndall of the anterior chamber 3+, the rest of the examination was impossible. No particularity was found in the right eye. A treatment based on valacyclovir 3g per os, dexamethasone eye drops, acetazolamide per os, local atropine, preservative-free artificial tears, sodium chloride 5% eye drops and vitamin A ointment.

One month later, the evolution was marked by the gradual decrease of intraocular inflammation and corneal edema and persistence of hypertonia. The progressive degression of valacyclovir and corticosteroid and an intensification of the dryness treatment led to a disparition of the inflammation with persistence of corneal edema sequelae.