Characteristic feature of Herpes Simplex Keratitis is-

Ans. is 'b' i.e., Dendritic Ulcer "The Dendritic ulcer is the most common presentation and is a typical lesion of herpes keratitis"* Most of the ocular infection are caused by HSV-1 except in neonates where eye infection can be caused by HSV-2 through infected genitalia of mother. Ocular involvement by HSV may occur in two forms: -A) Primary herpes: - Typically is a unilateral blepharoconjunctivitis which is characterized by vesicles on the skin of lids, follicular conjunctivitis, preauriculars adenopathy and sometimes punctate keratitis.B) Recurrent ocular herpes: - After primary infection, recurrent disease may involve any or all layers of the cornea. Recurrent herpatic keratitis is divided into: -1) Epithelial keratitis: - Manifestations of epithelial keratitis include: -i) Corneal vesicles: - Vesicles coalesce and erupt to form dendritic or geographic ulcer:ii) Superficial punctate keratitisiii) Dendritic ulcer: - It is the most common presentation and is a typical lesion of herpes keratitis. There is an associated marked diminution of sensation.iv) Geographic ulcer (amoeboid ulcer)2) Stromal keratitis: - Stromal keratitis may be of two types: -i) Disciform keratitis: - This is due to damage to endothelial cells as a result of hypersensitivity reaction to the HSV antigen.ii) Diffuse stromal necrotic keratitis: - Caused by active viral invasion and tissue destruction.3) Metaherpatic keratitis (Epithelial sterile trophic ulceration): - It is not an active disease, but is a mechanical healing problem at the site of previous herpetic ulcer.