Herpes Simplex Keratitis(1) starts as a linear pattern of inflammation and infection due to an active replicating virus along the distribution of the first branch of the trigeminal nerve. The dendrite is a linear pattern of opacification with edema of the epithelial cells. Chronic stromal keratitis may follow the epithelial infection, leading to ulceration and potential scarring. A granulomatous reaction to Descemet's membrane can occur as seen in the photo when there is full thickness stromal involvement. Back to Cornea