Herpes zoster ophthalmicus in an otherwise healthy 7 years child

A 07 years otherwise healthy child, non vaccinated for chickenpox and with a history of chickenpox infection at 02 years of age presented with red colored lesions in right upper lid, right side of forehead, vertex and right side of nose and defective vision in right eye in Mymensingh Medical College Hospital, 20 days after the appearance of blister in the same region. On examination granulation tissue was present on the same area. There was no hair and skin over that area. Lesion was strictly limited to right side of midline. Eyelashes of right upper lid were absent and there was defective closure of eyelids. Best corrected visual acuity of right eye was 3/60 and of left eye was 6/6. There was ciliary congestion of right eye with haziness of cornea at interpalpebral region of right eye. Corneal sensitivity was reduced and there was uniform fluorescein staining at central part of cornea. Mild flare and cells were present in anterior chamber. Fundus examination revealed no abnormality. He was treated with systemic acyclovir, antibiotics, topical acyclovir, antibiotic and atropine. Corneal ulcer and skin lesions were healed, but the patient developed cicatricial ectropion of right upper lid and best corrected visual acuity of right eye was reduced to 6/60 due to corneal opacity. So early diagnosis and treatment of herpes zoster ophthalmicus is mandatory to prevent sight threatening complications.