Varicella-zoster virus (VZV) is a Herpes virus responsible for chicken pox and shingles. With corneal epithelial involvement, the virus can cause punctate or dendritic epithelial keratitis. The pseudodendrites caused by VZV can be differentiated clinically from "true" dendrites caused by Herpes simplex virus (HSV). In contrast to HSV dendrites, VZV pseudodendrites are smaller in size, elevated without central ulceration, they do not have terminal bulbs, and have relative lack of central staining. Elevated mucous plaques may occur weeks to months after resolution of the original pseudodendrites. Residual corneal hypoesthesia after the infection can be severe.
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