Effect of Various Treatment Modalities on Dendritic Vial Ulcer

Study Overview
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Brief Summary
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Eye infection is a prevalent problem in primary care and remains a crucial healthcare concern. According to the American Academy of Ophthalmology (AAO), herpes simplex virus (HSV) keratitis (HSK) is the leading cause of infectious blindness worldwide . HSK is defined as a corneal inflammatory condition caused by the HSV infection . The global incidence of herpetic keratitis is estimated at 1.5 million per year, resulting in 40,000 new cases of severe visual impairment associated with corneal scarring and opacification . HSV type I (HSV-1) is by far the most predominant causative pathogen of eye infections]. HSV-1 is also known for causing orolabial herpes, HSV folliculitis, herpes gladiatorum, herpetic whitlow, and eczema herpeticum . HSV can be transferred to the eye by touching an active lesion and then the eye. The National Health and Nutrition Evaluation revealed a seroprevalence of HSV-1 in 53.9% of 14-49 year olds, and 90% of adults 50 years or older , indicating that the majority of the population has been exposed to this virus thus are at risk of developing HSK. In this study we evaluate the efficacy of different treatment modalities on viral keratitis HSK.

Official Title
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Effect of Various Treatment Modalities on Dendritic Vial Ulcer

Conditions
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Corneal Ulcer

Intervention / Treatment
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* Drug: Acyclovir
* Drug: Tobramycin
* Drug: Fluorometholone
* Drug: Sodium Hyaluronate


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: patients with epithelial viral ulcers - Exclusion Criteria: patients with stromal keratitis patients with corneal opacity

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| group 1'<br>patients with viral ulcers will receive antiviral medication with antibiotics | Drug: Acyclovir<br>* acyclovir 4 times /day<br>Drug: Tobramycin<br>* tobramycin 4 times /day<br>|
| group 2<br>patients with viral ulcers will receive antiviral medication, tear substitutes with antibiotics | Drug: Acyclovir<br>* acyclovir 4 times /day<br>Drug: Tobramycin<br>* tobramycin 4 times /day<br>Drug: Sodium Hyaluronate<br>* Sodium Hyaluronate 4 times/day<br>|
| group 3<br>patients with viral ulcers will receive antiviral medication, weak steroids(at the same time) with antibiotics | Drug: Acyclovir<br>* acyclovir 4 times /day<br>Drug: Tobramycin<br>* tobramycin 4 times /day<br>Drug: Fluorometholone<br>* Fluorometholone 4 times/ day<br>|
| group 4<br>patients with viral ulcers will receive antiviral medication with antibiotics followed by weak steroid after epithelial healing | Drug: Acyclovir<br>* acyclovir 4 times /day<br>Drug: Tobramycin<br>* tobramycin 4 times /day<br>Drug: Fluorometholone<br>* Fluorometholone 4 times/ day<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| healing of the epithelium | the epithelial healing assessed with flourescin stain and measured by slit lamp scale in millimetres and compared with pre treatment epithelial defect | 10 days follow up |