24/10/2020
Herpes Zoster Ophthalmicus (HZO), commonly known as shingles, is a viral disease characterized by a unilateral painful skin rash in one or more dermatome distributions of the fifth cranial nerve (trigeminal nerve), shared by the eye and ocular adnexa.
It occurs when reactivation of the latent virus (varicella-zoster) in the trigeminal ganglia involves the ophthalmic division of the nerve. The virus damages the eye and surrounding structures by secondary perineural and intraneural inflammation of sensory nerves.
Signs:
-Cutaneous lesions:
unilateral painful, red, vesicular rash on the forehead and upper eyelid, progressing to crusting after 2-3 weeks; resolution often involves scarring.
periorbital oedema (may close the eyelids and spread to opposite side)
lymphadenopathy (swollen regional lymph nodes)
-Ocular lesions:
Conjunctivitis
Zoster keratitis
Iridocyclitis
Retinal necrosis
Secondary glaucoma
Phisis bulbi
Treatment:
Systemic therapy
Local therapy
-usually treated with orally administered acyclovir. Other antiviral medications include famciclovir and valacyclovir. The antiviral medications are most effective when started within 72 hours after the onset of the rash.
-other secondary treatments:
Analgesics
Steroids
Anti-histamines
Anti-glaucoma
