Herpes Zoster Ophthalmicus

Herpes Zoster Ophthalmicus is due to a virus infection of the ophthalmic division of the
trigeminal nerve (CV). The virus is related to herpes virus varicella (Chicken pox).

Signs & Symptoms:
Appearance of vesicles strictly limited to one half of the forehead and spreading
the the tip of the nose if the naso-ciliary branch is involved.

Neuralgic pain may precede the rash by 24 to 48 hours.

Ocular Complications may include:
- red swollen eyelids
- ciliary injection
- oedema of cornea
- lowering of corneal sensation
- keratitis, localised lesion or complete bullous.
- uveitis
- secondary glaucoma
- episcleritis or scleritis
- optic neuritis
- ocular muscle paralysis

Treatment - This is directed towards protecting the cornea and preventing
secondary infections, and the use of drying antiseptics for the forehead.
If no signs of corneal involvement, local antibiotic drops to combat secondary
infection are sufficient.

If keratitis or uveitis follows then the use of Acyclovir eye ointment in
combination with topical steroids and mydriatics may be used under
ophthalmological supervision.

Analgesics are often requiered in large doses to relieve the neuralgia. There
may also be a place for the use of intravenous Acyclovir and high dose steroids
in the early stages to prevent the onset of neuralgia if the patient is seen early.