Initial infection with herpes simplex virus (HSV) is often characterized as a unilateral blepharoconjunctivitis (follicular type) with a vesicular skin rash, preauricular adenopathy, and, less commonly, punctate keratitis, although corneal involvement is more typical of reactivation or recurrent disease. This initial infection may be so mild as to be missed, but the recurrences produce the classic and more symptomatic keratoconjunctivitis. Corneal manifestations may involve any layer of the cornea, but the most common is the epithelial dendritic ulcer. In the United States, 50%-90% of adults have antibodies to herpes simplex virus type 1 (HSV-1), and HSV keratitis is the most frequent cause of corneal blindness. See HSV keratitis for more information.
Note: The focus of this summary is adult and child patients. For neonates and infants, consult a specialist.