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What Is a Dendritic Ulcer?

A dendritic ulcer is a corneal ulcer caused by the herpes simplex virus. It forms a branching pattern on the cornea that resembles the shape of a tree. These ulcers damage the corneal surface and can cause pain, redness, and blurry vision. Without proper treatment, the infection can worsen and lead to scarring. Early diagnosis helps prevent long-term vision problems.

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What Is a Dendritic Ulcer?

A dendritic ulcer is a corneal ulcer caused by the herpes simplex virus. It forms a branching pattern on the cornea that resembles the shape of a tree. These ulcers damage the corneal surface and can cause pain, redness, and blurry vision. Without proper treatment, the infection can worsen and lead to scarring. Early diagnosis helps prevent long-term vision problems.

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What Causes a Dendritic Ulcer?

The herpes simplex virus type 1 is the main cause. The virus often lies dormant in nerve tissue and reactivates during illness, stress, or immune suppression. Sun exposure and eye injuries can also trigger reactivation. Contact lens misuse increases irritation and risk. Recognizing triggers helps prevent recurrence.

What Symptoms Can Develop?

Symptoms include eye pain, tearing, redness, and sensitivity to light. Some people report a gritty sensation or burning. Blurry vision occurs when the ulcer affects the central cornea. The eyelids may become swollen. Severe discomfort usually leads patients to seek care quickly.

How Is a Dendritic Ulcer Diagnosed?

Doctors use fluorescein dye to highlight the ulcer's branching pattern. A slit-lamp exam confirms the shape and location. Viral testing is sometimes used for unclear cases. The distinct dendritic appearance makes diagnosis straightforward. Early evaluation helps determine the correct treatment.

What to Know Moving Forward

A dendritic ulcer is an urgent eye issue because it can scar the cornea and lead to lasting vision problems without fast treatment. Care usually involves prescription antiviral medication and close follow-up to confirm the ulcer is healing. Avoid contact lens wear until an eye doctor clears you, since lenses can worsen irritation and infection risk. If pain, redness, light sensitivity, or blurred vision increases, get emergency eye care.

Frequently Asked Questions About a Dendritic Ulcer

Is a dendritic ulcer contagious?

The virus itself is contagious, but the ulcer is a reaction on the cornea and does not spread between people.

Can the ulcer come back?

Yes. Herpes virus reactivation can cause recurrent corneal ulcers.

Can contact lenses make it worse?

Wearing lenses during infection can irritate the cornea and should be avoided.

Can it cause permanent vision loss?

Severe or repeated ulcers can scar the cornea and impair vision.

References

Herpes Simplex Epithelial Keratitis. EyeWiki (American Academy of Ophthalmology). https://eyewiki.org/Herpes_Simplex_Epithelial_Keratitis. Last edited May 9, 2025.

Herpes Simplex Keratitis. StatPearls (NCBI Bookshelf, NIH). https://www.ncbi.nlm.nih.gov/books/NBK545278/. Last Update March 10, 2024.

Corneal ulcers and infections. MedlinePlus Medical Encyclopedia (NIH). https://medlineplus.gov/ency/article/001032.htm. Updated July 9, 2024.

Antiviral treatment and other therapeutic interventions for herpes simplex virus epithelial keratitis. PubMed (National Library of Medicine, NIH). https://pubmed.ncbi.nlm.nih.gov/25879115/. Published 2015.

Update on the Management of Infectious Keratitis. PubMed (National Library of Medicine, NIH). https://pubmed.ncbi.nlm.nih.gov/28942073/. Published 2017.