HERPES ZOSTER OPTHALMICUS

Question 1

Clinical Features

Answer 1

Pain
Blurred vision
Photophobia
Red eye
Shingles in the trigeminal distribution w/o crossing midline
Hutchinson’s Signs (Shingles on tip of nose)
Pseudodentrite on slit lamp

a/w
Preceding pain & paresthesias
Headache
Fever
Malaise

Question 2

Management

Answer 2

Skin Lesions:

Cool compress

Acyclovir 800 mg
5 times daily
10 days
OR
Valcyclovir 1000 mg
tid
10 days

Bacitracin
Apply to affected lesions
1 - 3 times daily
Continue until lesions head

Ocular Lesions:
Erythromycin 0.5% Ointment
1 drop bid
Use until lesions have epithelialized

Associated Anterior Uveitis:
Cyclogyl (Cyclopentolate) 1%
1 drop tid

Opthalmology consult 24-48 hrs