Oral Valacyclovir Treatment of Herpes Zoster Ophthalmicus-Induced Optic Neuritis

Herpes zoster ophthalmicus (HZO) rarely manifests with complications of the optic nerve. The traditional standard of care for sight-threatening HZO infection involves intravenous hospital administration of the antiviral medication acyclovir. This case report entails an HZO complication invading the optic nerve, effectively treated by oral administration of the antiviral medication valacyclovir in an immunocompetent patient. Intravenous administration of antiviral medication may be undesirable for some patients with HZO due to comparative cost, stronger associations to nephrotoxicity, increased dosing frequency, and the need for hospitalization. Oral antiviral tablets have an efficacious route of administration to be considered over intravenous hospital administration when devising treatment for HZO with the rare complication of optic neuritis in immunocompetent patients.