The Herpetic Eye Disease Study was a series of randomized controlled trials that assessed the treatment and recurrence of ocular herpes simplex virus (HSV).

When supplemented with trifluridine, oral acyclovir wasn’t beneficial for resolution of active stromal keratitis or iridocyclitis (uveitis), compared to trifluridine alone. It also didn’t help prevent the progression of epithelial keratitis to stromal keratitis.

Oral acyclovir was found to be beneficial for recurrent HSV. It reduced the rate of recurrence by 50%!

Additionally, in a different section of the study, topical steroids were found to be helpful in hastening the recovery of HSV stromal keratitis and improving visually acuity in the first 6 months. However, after 6 months, whether or not steroids were used didn't have an impact on vision.

Beware, topical steroid use during the treatment of HSV epithelial keratitis can lead to geographic ulcers.

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