Dissemination of knowledge from randomized clinical trials for herpes simplex virus keratitis.

H erpes simplex virus type 1 (HSV), an enveloped virus with double-stranded DNA, is a major source of ocular infections. A 1982 study estimated that 400 000 people in the United States had ocular HSV infection, with 50 000 new and recurrent cases each year. Almost 20 years ago, the Herpetic Eye Disease Study Group was organized to elucidate the best treatments for HSV keratitis through the application of controlled, double-masked randomized clinical trials. The Herpetic Eye Disease Study trials demonstrated that topical corticosteroid with a prophylactic antiviral agent shortens the course of HSV stromal keratitis and that oral acyclovir prophylaxis significantly reduces recurrences. We surveyed eye care providers to examine the degree to which the best evidence-based practices (EBPs) in HSV keratitis have reached community care providers.