Oral acyclovir in the management of dendritic herpetic corneal ulceration

SUMMARY ' A controlled trial of oral acyclovir in herpetic dendritic corneal ulcers was carried out on 31 patients. All patients received minimal wiping debridement of the ulcer, following which they were randomly allocated to receive either oral acyclovir or placebo for 7 days. At the end of treatment 67 % of dendritic ulcers in patients receiving acyclovir had healed compared with 43 % in placebo recipients. The proportion of ulcers healed in the 2 groups at 7 days showed no significant difference (p=0- 18), but the rate of healing was significantly faster in the acyclovir group (p=0-03). Acyclovir is a potent antiviral agent with selective activity against virus infected cells. Many studies have shown that topical acyclovir is effective in the man-agement of superficial dendritic ulceration of the cornea.'- Satisfactory plasma and aqueous levels can be achieved following oral administration of acyclovir without toxic systemic effects.0'-3 There is evidence that systemic therapy with intravenous acyclovir is effective in the treatment of sever