|Year : 1982 | Volume
| Issue : 4 | Page : 353-354
Role of hermin in treatment of herpes simplex keretites
Bharti C Lavingia
M & J Institute of Ophthalmology, B.J. Medical College, Ahmedabad, India
Bharti C Lavingia
Eye Bank & Corneal Surgery Unit, B.J. Medical College, Ahmedabad
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Lavingia BC. Role of hermin in treatment of herpes simplex keretites. Indian J Ophthalmol 1982;30:353-4
The aim of treatment of herpetic keratitis is to halt the virus replication, to control the inflammation to prevent recurrence and to reduce tissue lysis.
Prostaglandin inhibitors, antihistaminics and drugs like disodium chromoglyconate were tried for herpes simplex in past as adjust to antiviral drugs.
Hermin is the aminoacid complex which may be acting at this stage probably by reducing tissue lysis. Certain other aminoacids like cystine has been tried in past. Hermin has been tried in the treatment of indolent corneal ulcer.
Hermin is available as a bottle of 200c.c. of Alembic Company. This is to be mixed with the same amount of Neosporine to prevent infection.
| Materials and methods|| |
Five groups of patients were selected in this study depending on clinical and biomicroscopic findings. First group comprised of 11 patients. Cases with epithelial herpetic ulcers like dendritic ulcer, were treated with (A) Iodine de-epithelization (B) Ridinox (IDU) eye drops 1 hrly and (C) Atropine 1 % eye drops iwice a day (D) Hermin+Neosporine eye drops were put four times a day along with the other drugs.
Second group ; Geographic ulcers- had 5 cases. They were treated (A) Ridinox eye drops 1 hrly (B) Atopine eye drops 1 % bd. and (C) Hermin+Neosporine eye drops qds.
Groups 3 ; cases of stromal herpes consisted of 5 cases. These cases were treated with all the drugs used for group II and over and above Dexona-Neomycine eye drops were added four times a day.
Group 4 ; recurrence of herpetic lesions. They were treated with atropine-ridinox and hermin+neosporine eye drops.
Group 5 ; consisted of four patients who were operated for lamellar keratoplasty for herpes simplex and had recurrence of disease in the graft. They were treated by Radinox eye drops I hrly and Hermin-1-Neosporinc eye drops qid. The treated was continued for I month.
Here vertical study has been presented instead of giving finding of all cases at one particular time as it is done in horizontal study. That means one example of each group is given along with complete follow up at intervals with photographic records to know the progress of disease.
| Observations|| |
Observations Group I : A female patient came with complaint of pain, redness and photophobia with diminished vision for 3 days. She had an epithelial ulcer which healed in four days. The conrea is completely clear in four weeks.
Group 2 : A young male patient had pain and redness for a 1 week. He had a geographical ulcer. The ulcer started healing in four days. The ulcer completely healed in three weeks. The cornea is clear except a small nebular opacity.
Group 3 : Example of group 3 was a patient referred to our hospital for non-healing corneal ulcer. There was a non-healing herpes ulcer with stromal involvement. He had already taken treatment for herpes simplex keratitis for one month before coming to our hospital. We added Hermin+Neosporine eye drops and dexona-N qds in this treatment.
After 2 days there was a good response. The size of the ulcer decreased. Subsequently Oedema dissappeared and ulcer healed with a thin nebuler opacity in about six weeks.
Group 4 : This case had herpes simplex. The ulcer healed in the five days. Patient stopped treatment after one month. He again had recurrence on 10.9.80. So same treatment started again and gave good response.
Group 5 ; Shows case of graft recurrence, This patient was operated for L.K. one year before. He developed herpetic ulcer in the graft on 5.7.80. He was treated with 'hermin'
+Neosporine'+Ridinox eye drops. After one week the ulcer healed.
| Discussion|| |
All cases of epithelial healed within 36 to 72 hours.
Geographical ulcers healed within 5 days.
Stromal herpes, recurrent herpes and graft infection took about one week to 10 days to heal.
From the above results it is evident that hermin hastens the healing of herpetic ulcers. May be due to collagenase activity or due to engymes like proteoglycan and cathispine-B, corneal ulcers particularly viral become indolent inspite of control of infection. This amino-acids complex added to the routine treatment may have some effect on these enzymatic activities and hastens healing of the herpes simplex infections.