What is the role of debridement in the management of herpes simplex virus (HSV) keratitis?

Updated: Jan 18, 2019
  • Author: Jim C Wang (王崇安), MD; Chief Editor: Andrew A Dahl, MD, FACS  more...
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Answer

A major problem related to therapy is the difficulty in achieving a precise debridement that does not damage the Bowman layer. Some forms of debridement are particularly harmful. The use of sharp instruments, cryotherapy, or strong chemicals (eg, phenol, iodine) should be avoided because they can cause unnecessary damage.

Adequate debridement can usually be achieved by brushing the epithelial lesions with a cotton-tipped applicator after applying a topical anesthetic drop. This technique is both convenient and effective; epithelial healing is rapid (usually within 48 hours) with resultant early disappearance of pain and discomfort. Any tendency for recurrent lesions to form in the early period after healing can be overcome by using a topical antiviral for 7-10 days after debridement.


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