Understanding of herpes simplex anterior segment disease needed for proper management

NAPLES, Fla. — Clinicians must understand the nature and behavior of herpes simplex anterior segment disease in order to manage it properly, according to a surgeon speaking here.

"My message is that understanding pathogenesis is the key to successful treatment," R. Doyle Stulting, MD, said in a presentation at the Florida Society of Ophthalmology annual meeting.

"I can't tell you how many times I've seen patients in consultation where there have been errors in management that occurred simply because the physician just did not understand what was going on," he said.

In managing patients with anterior segment herpes simplex disease, the physician must first classify the disease, determining the location and considering such factors as patient age, previous disease history and immune status, Dr. Stulting said. The physicians must also understand the nature of the disease — whether active viral replication is taking place, or host immune response or postinfection sequelae are occurring, he said.

Clinicians have limited options for selectively controlling the destructive inflammatory response, preventing recurrence and eliminating latent virus, Dr. Stulting said. A better understanding of natural resistance is also needed, he said.