Which finding supports the diagnosis of herpes keratitis when using fluorescein staining?

Which finding supports the diagnosis of herpes keratitis when using fluorescein staining?

• A. Visual acuity test only
• B. Slit-lamp examination without dye
• C. Fluorescein staining showing dendritic patterns indicating herpes keratitis
• D. Tonometry

Answer: (C)

Fluorescein staining under blue light exposes corneal epithelial defects, and herpes keratitis classically produces a branching, dendritic ulcer pattern. This dendritic pattern, often with terminal bulbs, is highly characteristic of herpes simplex keratitis and is the clearest, most specific finding when using fluorescein. Other options don’t reveal this pattern: visual acuity alone doesn’t visualize the corneal surface, examining without dye misses epithelial defects, and tonometry assesses intraocular pressure rather than corneal ulcers. So seeing a dendritic pattern on fluorescein staining best supports the diagnosis.

Fluorescein staining under blue light exposes corneal epithelial defects, and herpes keratitis classically produces a branching, dendritic ulcer pattern. This dendritic pattern, often with terminal bulbs, is highly characteristic of herpes simplex keratitis and is the clearest, most specific finding when using fluorescein. Other options don’t reveal this pattern: visual acuity alone doesn’t visualize the corneal surface, examining without dye misses epithelial defects, and tonometry assesses intraocular pressure rather than corneal ulcers. So seeing a dendritic pattern on fluorescein staining best supports the diagnosis.