Case Summary: Two pulmonary tuberculosis patients; a 49-year-old male and an 82-year-old male, was referred to our clinic. The patients simultaneously presented all types of HSV keratitis including marginal ulcers surrounding the entire perilimbal area, geographic ulcers and dendritic ulcers―despite only mild symptoms such as irritation or foreign body sensation and a relatively short disease course. They were treated by antiviral agent, than showed good prognosis.

Conclusions: Our findings suggest that neurotoxicity from anti-tuberculosis drugs specifically or a suppressed immune system associated with tuberculous infection itself may affect the perilimbal Herpes Simplex Virus reactivation, leaving a tuberculosis patient particularly vulnerable to herpetic keratitis.

Ann Optom Contact Lens 2015;14(3):158-162