Endothelial dysfunction after scleral lens use in patients with herpetic eye diseaseHerpes simplex virus and varicella zoster virus (VZV) affect approximately 4 billion individuals globally. When the infection involves the ophthalmic division of the trigeminal nerve (V1), they are termed “herpetic keratitis” (HK) and “herpes zoster ophthalmicus” (HZO). The estimated incidence of VZV is 4/1000 people, with approximately 10–20% of cases demonstrating ocular involvement.1 HK has been approximated to affect 1.5 million people with an estimated incidence of 11.8/100,000. Together, these are thought to be the leading cause of infectious ocular blindness in the developed world.
Management of patients with ocular neuropathic painThe cornea, although relatively small, measuring 11.5 mm in diameter and 0.5–0.8 mm in thickness, is one of the most densely innervated structures of the human body.1 The nerves of the cornea are susceptible to damage by noxious stimuli, resulting in perception of pain. If pain is apparent in response to benign stimuli, and/or beyond the phase of normal healing, this condition is aptly named “neuropathic pain.” Other terms used to describe this condition include “pain without stain,” “corneal neuralgia,” “keratoneuralgia,” and “corneal pain syndrome.” It has been demonstrated previously that development of keratoneuralgia can occur after iatrogenic intervention, systemic disease, and chronic dry eye.