Comm Eye Health Vol. 33 No. 108 2020 pp 91. Published online 30 March 2020.

Picture quiz

Close up image of the front of the eye - stained with fluorescein
Related content

A young person presented with a history of a sore left eye for 1 week following a febrile illness. The visual acuity was 6/18 in the left eye. The right eye was normal.

Question 1

What is the diagnosis?

a. Suppurative fungal keratitis

b. Neurotrophic keratitis due to herpes zoster

c. Episcleritis

d. Herpes simplex epithelial keratitis

e. Adenoviral punctate keratitis

Question 2

Which of the following are known risk factors for this condition?

a. Fever

b. Stress

c. Malaria

d. Iritis

e. Immune deficiency

Question 3

Which of the following can be used to treat this condition?

a. Aciclovir 3% eye ointment

b. Prednisolone 0.5% eye drops

c. Trifluorothymidine 1% drops

d. Timolol 0.5% eye drops

e. Ganciclovir 0.15% eye gel


1. d. This is a large dendritic ulcer probably due to herpes simplex virus.

2. a, b, c and e may all act as triggers for recurrence of herpes simplex infection.

3. a, c, and e are anti-viral medications which are effective against herpes simplex virus. Prednisolone should not be used. Timolol is used in glaucoma to lower intraocular pressure.