Could A Therapeutic Lens Spare A Corneal Procedure ?

 Corneal epithelial detachment is often associated with recurrent corneal erosions and bullous keratopathy The clinical picture combines redness, pain and tearing. Often in patients with a history of trauma, surgery, or corneal dystrophiesWe report an atypical case of recurrent epithelial basal membrane detachment following a herpetic infection and we would like to discuss the therapeutic possibilities for our patient.

 Ophthalmology departement, Mohammed VI university Hospital, oujda , Morocco

55-year-old patient, recurrent episodes of herpetic keratitis for 5 months in OS: VA at , with diffuse erosions, corneal edema, treated with valaciolovir 2g*3/d with surface treatment => good evolution but recurrence when treatment ended . second cure with good evolution and maintain a prophylactic dose. 2 weeks later, the patient presents for the recurrence of ocular pain, associated with tearing and ocular redness visual acuity at 0.5 conjunctival hyperemia punctate Corneal erosions Presence of an epithelial bulla below, no descemetocele, no clear signs of endotheliitis = maintain the same treatment and use of a therapeutic lens = Good evolution then reccurence again. a pucnture with an eventual PTK was suggested but refused by the paptient. we maintained the Therapeuric lens with valacicolvir once a day with good outcome , reapplication of epithelium and final BCVA at 10/10.

We report a rare case of epithelial detachment after viral keratitis Our case opens the discussion on the involvement of viruses in dystrophy of the epithelial basal membrane and in the syndrome of recurrent corneal erosions The treatment includes several means, but which remains poorly codified given the insufficiency of the studies