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Acyclovir + dexamethasone is a combination ophthalmic therapy developed for the treatment of herpetic stromal keratitis (HSK). This formulation combines the antiviral properties of acyclovir, a guanosine analogue, with the potent anti-inflammatory effects of dexamethasone, a synthetic glucocorticoid. In the context of HSK, acyclovir serves to inhibit viral DNA polymerase, thereby halting the replication of the Herpes Simplex Virus (HSV). Concurrently, dexamethasone acts as a glucocorticoid receptor agonist to suppress the immune-mediated inflammatory response and corneal neovascularization that often lead to corneal scarring and vision loss. This dual-action approach is particularly effective for the stromal form of the disease, where both active viral infection and significant host immune reactions are present. The drug is notably utilized as a hospital-made preparation by institutions such as Tongji Hospital affiliated with Tongji University School of Medicine.
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