Incidence, Recurrence, and Outcomes of Herpes Simplex Virus Eye Disease in Olmsted County, Minnesota, 1976-2007

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Abstract
Herpes simplex virus (HSV) is a common cause of corneal disease and is the leading infectious cause of corneal blindness among developed nations.1 Following the initial exposure and primary systemic infection, HSV establishes a latent infection in the trigeminal or other sensory ganglia. Reactivation of latent HSV in the sensory ganglia may lead to initial or recurrent disease in 1 or occasionally both eyes.2 Common ocular manifestations of HSV include blepharitis, conjunctivitis, keratitis, and uveitis. Posterior segment disease, such as acute retinal necrosis, is rare. Recurrence rates of ocular HSV after an initial episode have been estimated at 10% at 1 year, 23% at 2 years, 36% at 5 years, and over 60% at 20 years.3 Periodic reactivations in the cornea are particularly important, because the cumulative effect of reinfection may lead to stromal inflammation or neurotrophic keratitis, resulting in scar or perforation.4