Unusual clinical presentations of new-onset herpetic eye disease after ocular surgery

Abstract

Purpose: To report five cases of new-onset herpetic eye disease with unusual presentation after ocular surgery. Methods: Herpetic eye disease was suspected in five cases, three after cataract surgery and two after lamellar corneal transplantation surgery. Of these, four cases presented within 2-6 weeks of surgery. The clinical presentation was in the form of an epithelial defect, suspected epithelial down growth, graft oedema with unexplained anterior chamber inflammation and graft-host interface infection. A swab for viral detection with real-time polymerase chain reaction was performed in all the described cases. Results: Herpes simplex disease was detected in all cases. All cases responded to the antiherpetic medications. Conclusions: Our study shows that new-onset herpetic eye disease may occur after cataract surgery and lamellar corneal transplantation, and a high index of suspicion may be necessary for the diagnosis in such cases. © 2010 The Authors. Acta Ophthalmologica © 2010 Acta Ophthalmologica Scandinavica Foundation.