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Herpes zoster ophthalmicus in Malawi
1International Eye Foundation, Blantyre, Malawi, Africa.
Ophthalmology
|November 1, 1994
Summary
Herpes zoster ophthalmicus in young Africans, particularly those with HIV, leads to severe vision loss due to delayed treatment and limited access to antivirals. This study highlights the critical need for accessible eye care and early intervention in this vulnerable population.
Area of Science:
- Ophthalmology
- Infectious Diseases
- Public Health
Background:
- Herpes zoster ophthalmicus (HZO) is a significant cause of ocular morbidity.
- High seroprevalence of human immunodeficiency virus type 1 (HIV-1) in African populations complicates HZO management.
- Delayed treatment and lack of antiviral availability exacerbate HZO complications.
Purpose of the Study:
- To describe the complications and visual outcomes of HZO in young Africans.
- To assess the impact of delayed treatment and limited resources on HZO prognosis.
- To identify risk factors for poor visual outcomes in this specific demographic.
Main Methods:
- Prospective examination and follow-up of 27 consecutive HZO patients.
- Assessment of visual acuity and ocular complications.
- Documentation of treatment limitations based on local availability.
Main Results:
- Poor visual outcomes were prevalent, with 66% of eyes having visual acuity worse than 20/60.
- Forty percent of eyes experienced light perception or no light perception visual acuity.
- Severe keratouveitis and corneal perforation were common complications contributing to vision loss.
Conclusions:
- Young Africans with HZO face a high risk of substantial and irreversible visual impairment.
- The findings underscore the urgent need for improved access to timely HZO treatment, including antiviral therapy, in resource-limited settings.
- HIV-1 co-infection likely contributes to the severity and poor outcomes observed in this population.