Herpes zoster ophthalmicus

Question 1

Herpes zoster ophthalmicus (shingles) affects:

Answer 1

the skin supplied by the ophthalmic division of the trigeminal nerve.

The eye may be affected if the nasociliary branch is involved.

Question 2

Management

Answer 2

Immediate referral is necessary if:

• the eye is red
• vision is blurred or
• the cornea cannot be examined.

Apart from general eye hygiene, treatment usually includes:

• oral aciclovir
• famciclovir or
• valaciclovir

(provided this is commenced within 3 d of the rash appearing),

• and topical aciclovir 3% opth. ointment 4 hrly.