HEDS I
Purpose: To evaluate the efficacy of topical corticosteroids in treating herpes simplex stromal keratitis with topical trifluridine.

To evaluate the efficacy of oral acyclovir in treating herpes simplex stromal keratitis in patients receiving topical corticosteroids and trifluridine.

To evaluate the efficacy of oral acyclovir in treating herpes simplex iridocyclitis with treatment of topical corticosteroids and trifluridine.

Results: No significant benefits of oral acyclovir in treating stormal keratitis in patients recieving steroids and trifluridine.
Topical steroids are significantly better in reducing persistance and progression of stromal inflammation and shortening duration of HSV stromal keratitis.

HEDS II
Purpose: To determine whether early treatment with oral acyclovir of HSV ulcerations of the corneal epithelium prevents progression to stromal keratitis and iridocyclitis.

To determine the efficacy of low-dose oral acyclovir in preventing recurrent HSV eye infection in patients with previous episodes of herpetic eye disease.

To determine the role of external factors and behavioral factors on the induction of ocular recurrences of HSV eye infections and disease.

Results: For patients with HSV epithelial keratitis treated with topical trifluridine, no
apparent benefit of a 3 week course of oral acyclovir in preventing HSV stromal keratitis or iritis was seen during the subsequent year. Long-term oral prophylaxis of acyclovir is effective in reducing the rate of recurrent ocular HSV and is most important in patients with a previous history of HSV stromal keratitis.