Topical antiviral agents are the treatment of choice. The best agent to use should be
determined in immediate consultation with an experienced ophthalmologist. Current information suggests that a combination
of an antiviral nucleoside and interferon topically speeds healing. Agents such as vidarabine, trifluridine or acyclovir
have been used. Some ophthalmologists recommend concurrent debridement or other physical or physicochemical methods of
treatment, but these methods have not been adequately investigated to make firm recommendations.
Vaccinia Immune Globulin (VIG) is not recommended for the treatment of isolated vaccinial keratitis and may increase the risk of corneal scarring in vaccinia keratitis. There is some evidence in humans and animal models that more extensive corneal clouding can occur following VIG therapy. However, this appears to be more of a risk when large or multiple doses of VIG are administered. VIG therapy can be administered in the presence of vaccinial keratitis if it is needed to treat or prevent other sight-threatening complications of ocular implantation (e.g. upper lid infection) or other severe vaccine complications (e.g. eczema vaccinatum).
|
