Unusual clinical presentations of new-onset herpetic eye disease after ocular surgery

Purpose: To report five cases of new-onset herpetic eye disease with unusual presentation after ocular surgery. Methods: Herpetic eye disease was suspected in five cases, three after cataract surgery and two after lamellar corneal transplantation surgery. Of these, four cases presented within 26 weeks of surgery. The clinical presentation was in the form of an epithelial defect, suspected epithelial down growth, graft oedema with unexplained anterior chamber inflammation and grafthost interface infection. A swab for viral detection with real-time polymerase chain reaction was performed in all the described cases. Results: Herpes simplex disease was detected in all cases. All cases responded to the antiherpetic medications. Conclusions: Our study shows that new-onset herpetic eye disease may occur after cataract surgery and lamellar corneal transplantation, and a high index of suspicion may be necessary for the diagnosis in such cases.