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Management of ophthalmic zoster
1St. Paul's Eye Unit, Royal Liverpool University Hospital, UK.
Journal of Medical Virology
|January 1, 1993
Summary
Herpes zoster ophthalmicus frequently causes ocular complications and persistent pain, especially in older adults. Topical acyclovir is favored for eye issues, while specific medications help manage acute and chronic pain.
Area of Science:
- Ophthalmology
- Virology
- Neurology
Background:
- Herpes zoster ophthalmicus (HZO) is a reactivation of the varicella-zoster virus affecting the ophthalmic nerve.
- Ocular involvement in HZO can lead to significant visual impairment and chronic pain.
Purpose of the Study:
- To review the natural history of HZO, focusing on ocular complications and pain.
- To evaluate current treatment and prevention strategies for HZO.
Main Methods:
- Review of existing literature on herpes zoster ophthalmicus.
- Analysis of incidence and prevalence of ocular complications and pain.
- Evaluation of treatment efficacy for ocular disease and pain management.
Main Results:
- 50% of HZO cases develop intraocular complications, with anterior uveitis and keratitis being most common.
- Sight-threatening complications include neuropathic keratitis, glaucoma, and retinal necrosis.
- Acute pain affects 93% of patients, with 31% experiencing persistent pain at 6 months, particularly in elderly patients.
- Topical acyclovir is recommended for ocular complications; systemic steroids are not advised for pain prevention.
Conclusions:
- HZO has a significant impact on ocular health and quality of life due to persistent complications and pain.
- Effective management strategies include topical acyclovir for ocular issues and targeted pharmacotherapy for pain.
- Further research is needed on the role of systemic steroids and early oral acyclovir in HZO management.