Isolation of herpes simplex virus from the cornea in chronic stromal keratitis.

Although dendritic ulceration of the corneal epithelium due to herpes simplex virus (HSV) frequently resolves with minimal residual damage,' virus may penetrate the corneal stroma and initiate a chronic, recurrent inflammation with an associated fall in visual acuity. The signs of disease in such patients result from the immune response to the presence in the cornea of viral antigen,2 which may be expressed by complete or incomplete virus particles, or an antigen on the surface of infected cells and their nuclei.3 Despite the demonstration of viral antigen by immunofluorescence,4s and of virus particles by electron microscopy,'9 it has proved difficult to culture virus in chronic stromal keratitis. We report here the isolation of HSV from 2 such patients, one with chronic ulcerative keratitis and one with recurrent disciform keratitis.