Herpetic keratitis is a common condition which can produce severe complications. The pattern of disease created by the virus depends on an interaction of virus and host mediated mechanisms. The changes in the epithelium are a consequence of the cytopathic effect of the virus and are related directly to virus replication. Changes produced in the stroma are due to inflammatory mechanisms initiated by the presence of virus antigens. The treatment of epithelial disease is aimed at reducing virus replication. The treatment of stromal disease is directed towards suppressing inflammation without increasing virus replication. Various anti-viral agents are available and each has a different mechanism of action and properties which make each anti-viral agent more suitable in particular situations. Many clinical trials have been conducted which indicate the place of anti-viral agents. The management of stromal disease is more complicated and less information is available from clinical trials to indicate the best possible method of treatment.