Herpes Keratitis in a Patient Undergoing Treatment With Topical Mitomycin C

Purpose: To report a case of herpetic keratitis in a patient undergoing mitomycin C therapy for conjunctival squamous cell carcinoma. Method: Case report. Results: A 70-year-old man was referred to the Massachusetts Eye Research and Surgery Institution in consultation for a persistent redness in the right eye. He was diagnosed with conjunctival squamous cell carcinoma and treated with topical mitomycin C (MMC). The patient initially improved on topical MMC therapy. At the end of the second cycle of topical MMC, he complained of intense ocular pain and redness in the eye under treatment. A diagnosis of herpetic epithelial keratitis was made based on the clinical findings, and he was subsequently treated with 1 drop of trifluridine 9 times per day in the affected eye. The patient responded with dramatic improvement and resolution of symptoms. Conclusions: This case reports a reactivation of latent herpes simplex virus with productive ocular infection, triggered by MMC therapy and highlights the importance of awareness of this possible risk associated with the use of MMC.