67 Herpes Zoster Ophthalmicum

Herpes Zoster Ophthalmicum

Herpes zoster ophthalmicum is reactivation of a varicella-zoster virus infection (shingles) involving the eye.

Symptoms and signs, which may be severe, include dermatomal forehead rash and painful inflammation of all the tissues of the anterior and, rarely, posterior structures of the eye.

  • Herpes zoster ophthalmicus may directly involve the eye and/or the skin around the eye, or may occur without ocular involvement, where only the skin of the V1 dermatomal region is affected

  • Refer to ophthalmology if a patient has ocular symptoms or signs

Diagnosis is based on the characteristic appearance of the anterior structures of the eye plus zoster dermatitis of the first branch of the trigeminal nerve (V1)

Trigeminal nerve distribution
trigeminal dermatome (V1) invovlement of herpes zoster ophtalmicum

References:

  1. Ting, Darren Shu Jeng; Ghosh, Niru; Ghosh, Saurabh (2019). Herpes zoster ophthalmicus. BMJ, (), k5234–. doi:10.1136/bmj.k5234 
  2. https://www.msdmanuals.com/professional/eye-disorders/corneal-disorders/herpes-zoster-ophthalmicus