Herpes Zoster Opthalamicus

Question 1

What is herpes zoster opthalmicus

Answer 1

1. Infection of ophthalmic division of the trigeminal nerve
   *reactiviation of dormant varicella virus
2. Involvement of tip of the nose or lid margin, and eye

Question 2

What are the signs of herpes zoster ophthalmicus

Answer 2

1. Fever, headache malaise
2. Peri-orbital burning, pruritus THEN
3. Eruption of lesions/rash
   *vesicular then pustular and crusting
   *+Corneal dendrites may be difficult to distinguish form HSK

Question 3

What needs to happen if a patient presents with herpes zoster ophthalmicus

Answer 3

Emergent referral for ophthalmology consultation
*within 72 hours after appearance of rash

Question 4

What is the treatment of herpes zoster ophthalmicus

Answer 4

PO antiviral agent
*high dose acyclovir, valacyclovir, or Famciclovir

Question 5

If there is evidence of anterior uveitis what is the treatment

Answer 5

1. Topical corticosteroids and cycloplegics

Question 6

What is the prognosis of HSO

Answer 6

1. Neurotrophic keratitis
2. Posterior subcapsular cataracts