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Ophthalmology · Cornea: herpes simplex keratitis
Sample itemA patient has a branching corneal ulcer with terminal bulbs that stains with fluorescein. What is the initial treatment?
Original practice item, not a recalled exam question. Nothing here is recorded.
The answer and the reasoning
C. Topical acyclovir 3 percent ointment
This is a dendritic ulcer of epithelial herpes simplex keratitis. Topical antivirals such as acyclovir or ganciclovir are used, and steroids are contraindicated in active epithelial disease.
Option by option
A. Topical natamycin
Natamycin is for fungi.
B. Topical timolol
Timolol is an antiglaucoma drug.
C. Topical acyclovir 3 percent ointment (correct)
Correct. Antiviral treatment is indicated.
D. Topical prednisolone
Steroids spread epithelial herpetic disease into geographic ulcers.
Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.
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