Alternate Herpes Simplex Virus-Associated Inflammation in the Cornea and Retina Within a Span of over Two Decades: A Case Report

Purpose: To report a case of alternate herpes simplex virus (HSV)-related inflammation in the cornea and retina in over two decades. Methods: Penetrating keratoplasty was performed for HSV stromal keratitis, which had occurred repeatedly over the earlier 7 years, in 2004, and vitrectomy was performed for acute retinal necrosis (ARN) in 2021 in the right eye of the patient. Systemic and topical antivirals and immunosuppressants were administered for HSV reactivation. Results: The viruses remained quiescent for 17 years after keratoplasty until reactivation occurred and triggered ARN. The retina became reattached after vitrectomy. One year after the onset of ARN, the eye developed HSV epithelial keratitis. The opacified corneal graft recovered transparency 1 week after medical treatment. Conclusion: HSV may cause inflammation in different eye tissues within a long time. It is important to be aware of the possibility of uveitis or retinitis in patients with a history of HSV keratitis.