• The clinical differentiation of corneal epithelial lesions due to herpes simplex or herpes zoster may be confusing. Practical clinical tests, including the use of topical ocular stains, are useful to differentiate corneal epithelial lesions caused by these two viruses. Two distinctive types of zoster corneal epithelial disease may be seen: an early dendritic form, and a delayed form characterized by corneal mucus plaques that may take a dendriform pattern. These plaques are composed of mucus that is adherent to swollen, degenerating epithelial cells. The clinical differentiation between these two viruses is essential since topically applied corticosteroids are contraindicated in epithelial herpes simplex and often are indicated in the management of epithelial herpes zoster.
Marsh RJ, Fraunfelder FT, McGill JI. Herpetic Corneal Epithelial Disease. Arch Ophthalmol. 1976;94(11):1899-1902. doi:10.1001/archopht.1976.03910040609004