Herpes Zoster Ophthalmicus

Question 1

What is herpes zoster ophthalmicus?

Answer 1

Reactivation is the varicella zoster virus in the area supplied by the ophthalmic division of the trigeminal nerve

Question 2

What are the features of herpes zoster ophthalmicus?

Answer 2

Vesicular rash around eye
Hutchinsons sign rash on tip of nose or side of nose- indicates nasociliary involvement and is a strong RF for ocular involvement

Question 3

What is the management of herpes zoster ophthalmicus?

Answer 3

Oral antiviral treatment for 7-10 days ideally started within 72hrs

In v severe cases IV antivirals can be used

Topical corticosteroids May be used to treat any secondary inflammation of the eye.

Ocular involvement requires urgent ophthalmology review

Question 4

What are the complications of herpes zoster ophthalmicus?

Answer 4

Ocular: conjunctivitis, keratitis, episcleritis, anterior uveitis
Ptosis
Post hermetic neuralgia