Ophthalmic herpes Zoster

Abstract

London SUMMARYA current review of ophthalmic zoster is presented including its virology, immunology, epidemiology and pathogenesis. We give our findings in 1356 patients referred to the Zoster Clinic at Moorfields Ey e Hospital, London. The treatment of the disease and its ocular com plications is discussed.Ophthalmic herpes zoster is a disease varying in severity from devastating, threatening life and sight, to so mild that it may pass unnoticed. The ophthalmic division of the fifth cranial nerve is affected in 7-17.5% of herpes zoster patients. 1-5 Ocular involvement complicates approxi mately 50% of these cases and very rarely cases of maxil lary herpes zoster,l affecting many of the tissues of the globe and orbit by highly varied types of lesions.

Scleromalacia as a complication of herpes zoster ophthalmicus

“…Reported scleral complications of herpes zoster ophthalmicus (HZO) include episcleritis, scleritis, [1][2][3][4] and scleromalacia. 5,6 Scleromalacia is an exceedingly rare complication of HZO and it can pose a diagnostic problem to the unwary ophthalmologist.…”

“…Scleritis and episcleritis can recur in subsequent years, resulting in scleral atrophy. 1 We describe a female patient who developed scleromalacia without a history of pain and precipitating scleritis, 1 1 2 years after being diagnosed with HZO.…”

“…1 However, when scleromalacia was an outcome, all patients had a severe acute attack of HZO complicated most commonly by iridocyclitis and raised intraocular pressure.…”

“…1,2 It can give rise to intermittent microhyphaemas, pigment dispersion, transient rise in intra-ocular pressure and, less commonly, progress to pigmentary glaucoma.…”

Herpes zoster ophthalmicus reduction: implementation of shingles vaccination in the UK

“…This may be a swollen or ptotic eyelid, conjunctivitis, or keratitis that may reduce vision. Most cases of eye involvement develop within 3-4 weeks of initial primary care diagnosis 11 and completion of an initial course of antiviral therapy. Following an initial acute phase, HZO may become chronic or relapsing in nature, and may require years of treatment.…”