This virus can affect many different parts of the eye. Dendritic ulcers can occur on the surface of the corneal epithelium which shows up under fluorescein stain as a branching lesion. This is treated topically with ganciclovir gel 5 times a day for 1 week. It can also cause deeper infection (disciform keratitis) which often needs a combination of oral antivirals, topical ganciclovir and steroid drops. This may take weeks/months to resolve. In some cases corneal scarring can occur. Be suspicious of HSV infection if someone has had prior HSV keratitis/uveitis and if someone has had a recent flare up of HSV around their mouth.
Who to refer
Please see Lothian GP and optometry ophthalmology referral pathway.
Urgency of the condition for details on how soon patients should receive an appointment.
Patients who present with a problem with their only seeing eye should be advised to see an optician/ophthalmologist for review.
How to refer
We require a referral letter for EVERY patient.
The preferred referral process is via SCI Gateway. If sending/forwarding a referral via SCI gateway please include past medical history, allergies and medications
If you do not have access to fax or SCI Gateway e.g. if you have arranged an appointment out of hours please send a written referral letter with the patient to bring to their appointment.
Only if SCI Gateway is unavailable should a letter be typed or handwritten. Please write legibly and include your examination findings.
If you have arranged an appointment in the acute referral clinic and you are referring from within another hospital in Lothian please use TRAK to type the referral letter.
