Table 1.

Classification and Treatment of Herpes Simplex Virus Ocular Infection

Classification	Alternate Terms	Treatment Recommendations
Epithelial Keratitis	Dendritic Ulcer Geographic Ulcer	Therapeutic dose of oral or topical antiviral Acyclovir 400 mg 3–5 times daily for 7–10 days Valacyclovir 500 mg twice daily for 7–10 days Famciclovir 250 mg twice daily for 7–10 days Trifluridine 1% 1 drop 9 times daily for 7 days (not to exceed 21 days) Acyclovir 3% ointment 5x daily for 7 days Ganciclovir ointment 0.15% 1 drop 5 times daily for 7 days Also consider: Epithelial debridement
Stromal Keratitis without ulceration	Interstitial keratitis Immune/Wessely Ring	Prednisolone acetate 1% 4 times daily. Taper slowly to lowest dose required to control inflammation Prophylactic oral antiviral Acyclovir 400 mg 2 times daily Valacyclovir 500 mg daily Famcicylovir 250 mg daily
Stromal Keratitis with ulceration	Necrotizing stromal keratitis Ulcerating interstitial keratitis	Prednisolone acetate 1% 1 to 4 times daily Therapeutic dosage of oral antiviral Acyclovir 800 mg 5 times daily for 7–10 days Valacyclovir 1 gm 3 times daily for 7–10 days Famcicylovir 500 mg 2–3 times daily for 7–10 days
Endotheliitis	Disciform keratitis Disciform endotheliitis Linear endotheliitis	Therapeutic dose of oral antiviral Acyclovir 800 mg 5 times daily Valacyclovir 1 gm 3 times daily Famcicylovir 500 mg 2 times daily Prednisolone acetate 1% 4 times daily