24 year old female with head aches and 20/50 vision OS has a corneal scar with underlying KPs (see photos) and IOP of 42 (see attached gone picture). What is the most likely diagnosis and you course of treatment
Corneal scar with KPs with elevated IOP is suugestive of HSV keratitis with trabeculitis. The gonio picture demonstrates fine KPs in the TM with some pigment in the schwalbe's area. Treatment consists of PF to treat the trabeculitis and stromal keratitis along with oral acyclovir to suppress the HSV virus. Glaucoma medocations hav eto be given including possible oral acetazolamide since the IOP so high along with topical beta blockers.