[Clinical and diagnostic developments in corneal herpes].

The indications for keratoplasty in treating herpes keratitis are currently declining because of recent progress in diagnosis and treatment. Clinically, corneal signs may be caused by HSV reactivation or a secondary anti-HSV immune response. Corneal opacification may be acute or the expression of sequela (meta-herpetic keratitis). The virus can be detected on a corneal surface sample by direct examination or cell culture, the only way to detect an infective virus. The detection of local antibody production in the aqueous humor is an inexpensive method, indicating the local immune anti-HSV response. Detection of HSV DNA using PCR is more sensitive, but the presence of HSV DNA within corneal tIssue may be more delicate to interpret. It is now proven that HSV can be transmitted through a corneal graft from donor to recipient, but no diagnostic test currently detects potentially infective corneas in eyebanks.