Posterior corneal infiltrates and iritis common. Infiltrates have feathery borders, may be surrounded by satellite lesions. Can occur without corneal trauma in immunocompromised. Herpes simplex - Unilateral, follicular conjunctival reaction, may be recurrent, may have skin vesicles along eyelid margin or around eyes, may have palpable preauricular node. May have dendritic keratitis.
Dendrites have terminal bulbs, arboral pattern.
Edges of herpetic corneal lesions have a heaped up appearance and stain well with rose bengal, central ulceration stains well with flouroscein. Herpes zoster - Vesicular lesions of face in trigeminal nerve distribution, does not cross midline. Epithelial dendrites present on cornea, do not have terminal bulbs, do not stain well with flouroscein. Infectious corneal ulcer - red eye, mild to severe pain, photophobia, decreased vision, discharge, focal white opacity in the corneal stroma with overlying epithelial defect. Epithelial defect stains with flouroscein, shows stromal loss.