Which finding on examination is most consistent with herpes simplex keratitis?

Which finding on examination is most consistent with herpes simplex keratitis?

• A. Bacterial keratitis
• B. Corneal abrasion
• C. Dendritic lesions on fluorescein staining indicating herpes keratitis
• D. Allergic conjunctivitis

Answer: (C)

Herpes simplex keratitis classically shows dendritic epithelial ulcers on fluorescein staining. These branching, linear ulcers with terminal bulbs become visible under blue light and are highly characteristic of HSV infection of the cornea. This pattern helps distinguish it from other red-eye conditions: bacterial keratitis tends to have a focal, often purulent infiltrate; a simple corneal abrasion is a superficial defect without the branching dendritic pattern; allergic conjunctivitis presents with itching, redness, and tearing rather than corneal dendrites. So seeing dendritic lesions on fluorescein staining best fits herpes simplex keratitis.

Herpes simplex keratitis classically shows dendritic epithelial ulcers on fluorescein staining. These branching, linear ulcers with terminal bulbs become visible under blue light and are highly characteristic of HSV infection of the cornea. This pattern helps distinguish it from other red-eye conditions: bacterial keratitis tends to have a focal, often purulent infiltrate; a simple corneal abrasion is a superficial defect without the branching dendritic pattern; allergic conjunctivitis presents with itching, redness, and tearing rather than corneal dendrites. So seeing dendritic lesions on fluorescein staining best fits herpes simplex keratitis.