Herpes Zoster Ophthalmicus
Herpes zoster ophthalmicus is infection of the eye caused by varicella-zoster virus.
Herpes zoster is a virus that grows in nerves and may spread to the skin, causing shingles (see Section 17, Chapter 198). If the forehead or nose becomes infected, the eye is also likely to become infected, on the same side as the skin involvement.
Infection of the eye produces pain, redness, and eyelid swelling. An infected cornea can become swollen, severely damaged, and scarred. The structures behind the cornea can become inflamed (uveitis), the pressure in the eye can increase (glaucoma), and the cornea can become numb, which can lead to injuries. The appearance of active shingles, a history of the typical rash, or old scars from a shingles rash help a doctor make the diagnosis.
When herpes zoster infects the face and threatens the eye, early treatment with acyclovir, valacyclovir or famciclovir, which are taken by mouth, reduces the risk of eye complications. Corticosteroids, usually in eye drops, may also help. Eye drops, such as atropine, are used to keep the pupil dilated, to help prevent a severe form of glaucoma, and to relieve pain.
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