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Are these medicines the apt ones for keratitis?

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The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.

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Published At May 16, 2016
Reviewed AtJune 30, 2023

Patient's Query

Hi doctor,

I am suffering from stromal viral keratitis. My doctor mentioned in my report as stromal keratitis (herpes). Is that herpes? Also I was prescribed Pred forte, Add Tears and Acivir ointment. Are these right medicines? This is the second episode after five years. Please help.

Hello,

Welcome to icliniq.com. Let me share some facts about viral infection of eye. Primary viral infection of the eye is usually followed by recurrent infection that may involve any or all layers of cornea. Cornea has three layers: epithelium, stroma and endothelium. It is when the stroma affected it causes stromal keratitis. This may be due to direct infection or your own body's immune response to viral antigens. Most common viral keratitis is herpes simplex viral keratitis. Stromal keratitis is usually recurrent. The treatment prescribed to you is according to the protocol. You need to ensure that you use them accordingly and apply topical medication five times daily. The response should be evident by two to four days. If not then you can change from Acyclovir to Ganciclovir ophthalmic gel 0.15% five times daily or Trifluridine 1% drops nine times daily. Topical corticosteroid Pred Forte (Prednisolone) is to bring down your immune response and is thus indicated in immune mediated non-necrotizing stromal keratitis. Debridement can sometimes be tried according to the lesion. Antiviral medications should not be taken for more than 10 to 14 days as they cause epithelial toxicity. Patients with frequent recurrences of ocular HSV may be placed on a long-term regimen of oral antiviral medication at the prophylactic maintenance dose. Valacyclovir has been shown to be as effective as Acyclovir in reducing the recurrence of ocular HSV disease. Have a word word with your treating physician if you are worried about recurrence. Take care.

Patient's Query

Hi doctor,

Five years back I had stromal keratitis. At that time doctor prescribed me Alcon Pres, Refresh Tears and Acivir. Shall I use the same this time?

Hi,

Welcome back to icliniq.com. Alcon has many ophthalmological products. For what have you been prescribed Alcon Pres? Is that for glaucoma? Any way you need not change or add any medication. Just wait for recovery. If the present condition persists or does not come down in a week then you can think about it. For now continue your same medication. All the best.

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Geetha Priyadarsini Kamminana
Dr. Geetha Priyadarsini Kamminana

Internal Medicine

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