Herpes Zoster Ophthalmicus

Herpes Zoster Ophthalmicus

Alexandra Ortego

Paul Petrakos


Herpes zoster, commonly known as shingles, occurs when the human herpesvirus type 3, the virus responsible for varicella infection, is reactivated in the neurosensory ganglia, often years or decades after the primary infection. Herpes zoster classically results in a unilateral inflammatory reaction causing pain and a vesicular rash in the distribution of a neurosensory dermatome (Figure 32.1). According to the Centers for Disease Control and Prevention, there are an estimated 1 million annual cases of herpes zoster in the United States, and nearly one in three people will develop herpes zoster in their lifetime.1 Herpes zoster ophthalmicus (HZO) is a commonly encountered disorder in emergency departments (EDs) and urgent care settings and accounts for 10% to 20% of herpes zoster cases.2

Herpes zoster and HZO primarily affect the elderly and immunocompromised. Decreased cellular immunity as a result of advanced age, immunosuppression, or physical stress allows the virus that had been dormant for years and suppressed by the immune system to reactivate. Early diagnosis, treatment with antivirals, and, when there is concern for eye involvement, ophthalmologic consultation is essential in decreasing the duration of symptoms and complications of herpes zoster and HZO such as permanent vision loss, prolonged or permanent pain, and scarring.

Apr 18, 2023 | Posted by in OTOLARYNGOLOGY | Comments Off on Herpes Zoster Ophthalmicus

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