Nummular keratitis is a feature of viral keratoconjunctivitis. It is a common feature of adenoviral keratoconjunctivitis (an ocular adenovirus infection), as well as approximately 1/3rd of cases of Herpes Zoster Ophthalmicus infections. It represents the presence of anterior stromal infiltrates. Unilateral or bilateral subepithelial lesions of the cornea may be present. Slit lamp examination reveals multiple tiny granular deposits surrounded by a halo of stromal haze. After healing, residual nummular scars often remain. Disciform keratitis occurs in 50% of individuals with Nummular keratitis, but Nummular keratitis always precedes Disciform keratitis. Treatment
Lubricating eye drops
Topical dilute steroid drops in tapering doses (debatable, see: Adenoviral keratoconjunctivitis)


== References ==
They have also been shown to protect mice from a lethal challenge with several TBE-virus isolates obtained over a period of more than 30 years from all over Europe and the Asian part of the former Soviet Union. In addition, it has been demonstrated that antibodies induced by vaccination of human volunteers neutralized all tested isolates. Pregnancy and breastfeeding
The vaccine appears to be safe during pregnancy, but because of insufficient data the vaccine is only recommended during pregnancy and breastfeeding when it is considered urgent to achieve protection against TBE infection and after careful consideration of risks versus benefits. Schedule
Two to three doses are recommended depending on the formulation. Typically one to three months should occur between the first doses followed by five to twelve months before the final dose. Additional doses are then recommended every three to five years. A study from 2006 suggests that the FSME-Immun/Ticovac and Encepur are interchangeable for booster vaccination, but cautions against change during the primary immunization course. History
The first vaccine against TBE was prepared in 1937 in the brains of mice. Some 20 years later TBE vaccines derived from cell cultures (chicken embryo fibroblast cells) were developed and used for active immunization in humans in the former Soviet Union. Later, a purified, inactivated virus vaccine was developed which proved to be more immunogenic than previous TBE vaccines. Society and culture
Economics
Per dose it costs between £50 and £70 in the United Kingdom. Brand names
Brand names of the vaccines include Encepur N, FSME-Immun CC and Ticovac, Encevir-Neo, Klesh-E-Vak.