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Emergency: requires immediate attention
Herpes zoster ophthalmicus in Adult
See also in: External and Internal Eye
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Emergency: requires immediate attention

Herpes zoster ophthalmicus in Adult

See also in: External and Internal Eye
Print Images (19)
Other Resources UpToDate PubMed

Synopsis

Herpes zoster ophthalmicus (HZO) is a recurrence of the varicella-zoster virus in the distribution of the ophthalmic branch of the trigeminal nerve (VI). Classically, this reactivation occurs in healthy patients in or beyond their sixth decade. HZO is also more common in debilitated patients due to illness, trauma, stress, or immunosuppression (secondary to chemotherapy, HIV, radiation, malignancy, etc). Early symptoms can begin as dysesthesias of the forehead and brow. A vesicular rash that respects the midline can then develop, involving the forehead, brow, eyelids, and, at times, the conjunctiva. Involvement of the tip of the nose (Hutchinson sign) increases the chances of ocular involvement. The rash can be quite severe or mild enough to be mistaken for acne. A red eye on the involved side indicates ocular involvement. HZO often causes conjunctivitis and can involve other structures of the eye, causing a dendritic keratitis, uveitis, and, less commonly, retinitis.

Once the acute phase of HZO has healed, a chronic inflammatory course with frequent exacerbations can persist, causing progressive corneal scarring and neurotrophic keratoconjunctivitis. Chronic recurrent HZO (long after the rash has healed) can be very difficult to treat and may lead to corneal scarring and neovascularization. Post herpetic neuralgia can also be a very difficult situation for both patients and physicians to deal with. Cerebrovascular accidents have been associated with zoster.

Codes

ICD10CM:
B02.30 – Zoster ocular disease, unspecified

SNOMEDCT:
87513003 – Herpes zoster ophthalmicus

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Therapy

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Last Updated: 10/27/2017
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Emergency: requires immediate attention
Herpes zoster ophthalmicus in Adult
See also in: External and Internal Eye
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Herpes zoster ophthalmicus (Prodrome) : Eye pain, Fever, Headache, Corneal dendritic ulcer, Malaise, Unilateral
Clinical image of Herpes zoster ophthalmicus
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