Steroids and Herpes Simplex

It has now become almost axiomatic that the diagnosis of herpes simplex of the cornea in any shape or form automatically contraindicates the use of steroids either locally or systemically. Although there have been several reports of fulminating corneal disease in herpes simplex treated with steroids, the great bulk of this objection stems from work done in the rabbit eye. It seems undoubtedly true that steroid drugs have a deleterious effect upon the healing of herpes simplex in the rabbit cornea. Clinical experience has made me believe that there are times in the life cycle of corneal herpes when the administration of local or systemic steroid drugs is not only not contraindicated but, in fact, is almost mandatory if the best interest of the patient is to be served. In the present state of our knowledge I would agree that in acute, purely epithelial, herpes simplex of the cornea there