Which medication type is generally contraindicated in patients with herpetic keratitis?

Topical steroids are generally contraindicated in patients with herpetic keratitis because they can exacerbate viral infections. In cases of herpetic keratitis, the herpes simplex virus can cause inflammation and damage to the corneal epithelium. The use of topical steroids may suppress the local immune response, allowing the virus to replicate more freely and potentially lead to more severe disease, corneal scarring, or even vision loss.

While other medication types listed have specific roles, they do not carry the same risk of worsening a viral infection. For example, topical NSAIDs might help with pain management, mydriatics can assist with cervical muscle spasms, and antihistamines are typically used to manage allergy symptoms, none of which have the same detrimental effect on a viral keratitis condition as topical steroids. Thus, the particular mechanism by which steroids can worsen herpetic infections is key to understanding why they are contraindicated in this situation.