Unilateral Posterior Interstitial Keratitis as a Clinical Presentation of Herpes Simplex Virus Disease

Purpose: To describe a case series of patients with unilateral, posterior interstitial keratitis presumed to be caused by herpes simplex virus. Methods: Retrospective case series. Results: Five patients were found to have unilateral, posterior interstitial keratitis. Three of the involved eyes had decreased corneal sensation, and 2 eyes had corneal stromal neovascularization. All patients were treated with topical steroids and an oral antiviral, and among those with long-term follow-up, clinical improvement required treatment over an extended duration. A review of the literature revealed 1 reported case with a similar clinical appearance, although that case was attributed to Lyme disease. Conclusions: The clinical presentation of unilateral, posterior interstitial keratitis may be a rare manifestation of herpes simplex virus keratitis.