Herpes zoster ophthalmicus - Revision history

Rossdonaldson1 at 17:13, 4 February 2026

2026-02-04T17:13:57Z

← Revisión anterior		Revisión del 17:13 4 feb 2026
Línea 7:		Línea 7:

	{{Herpes viruses}}		{{Herpes viruses}}
			{{Conjunctivitis DDX}}

	==Clinical Features==		==Clinical Features==
Línea 21:		Línea 22:

	==Differential Diagnosis==		==Differential Diagnosis==
	~~{{Conjunctivitis DDX}}~~

	{{VZV types}}		{{VZV types}}

	{{HIV associated conditions}}		{{HIV associated conditions}}
			{{Unilateral red eye DDX}}
			{{Bilateral Red Eyes}}

	==Evaluation==		==Evaluation==

Rossdonaldson1: /* Background */

2023-07-12T21:13:28Z

Background

← Revisión anterior		Revisión del 21:13 12 jul 2023
Línea 5:		Línea 5:
	**Nasociliary branch of V1 innervates both the lateral/tip of nose as well as the cornea		**Nasociliary branch of V1 innervates both the lateral/tip of nose as well as the cornea
	*Consider immunocompromise in patients <40yrs		*Consider immunocompromise in patients <40yrs

			{{Herpes viruses}}

	==Clinical Features==		==Clinical Features==

Elcatracho: /* Clinical Features */

2021-02-09T02:20:40Z

Clinical Features

← Revisión anterior		Revisión del 02:20 9 feb 2021
Línea 13:		Línea 13:
	*Vesicular [[rash]] in V1 distribution		*Vesicular [[rash]] in V1 distribution
	*[[Slit-lamp exam]]:		*[[Slit-lamp exam]]:
	**Pseudodendrite (poorly staining mucous plaque with no epithelial erosion		**Initial finding of punctate epithelial keratitis that then evolves into pseudodendrite<ref>Li, J. Y. (2018). Herpes zoster ophthalmicus. Current Opinion in Ophthalmology, 29(4), 328–333. doi:10.1097/icu.0000000000000491 </ref>
			**Pseudodendrite (poorly staining mucous plaque with no epithelial erosion)
	***In contrast to [[HSV]] which has true dendrite with epithelial erosion and staining		***In contrast to [[HSV]] which has true dendrite with epithelial erosion and staining
	**Cell and flare		**Cell and flare

Rossdonaldson1: /* Clinical Features */

2020-09-26T19:22:44Z

Clinical Features

← Revisión anterior		Revisión del 19:22 26 sep 2020
Línea 7:		Línea 7:

	==Clinical Features==		==Clinical Features==
	[[File:Herpes zoster ~~ophthalmicus~~.jpg\|thumb\|Herpes zoster ophthalmicus]]		[[File:Herpes zoster ophthalmicus2.jpg\|thumb\|Herpes zoster ophthalmicus]]
	*Prodrome of [[headache]], malaise, photophobia, [[fever]]		*Prodrome of [[headache]], malaise, photophobia, [[fever]]
	*Unilateral [[eye pain\|pain]] or hypesthesia in V1 distribution		*Unilateral [[eye pain\|pain]] or hypesthesia in V1 distribution
Línea 15:		Línea 15:
	**Pseudodendrite (poorly staining mucous plaque with no epithelial erosion		**Pseudodendrite (poorly staining mucous plaque with no epithelial erosion
	***In contrast to [[HSV]] which has true dendrite with epithelial erosion and staining		***In contrast to [[HSV]] which has true dendrite with epithelial erosion and staining
	**Cell and flare		**Cell and flare

	==Differential Diagnosis==		==Differential Diagnosis==

Rossdonaldson1 at 19:10, 26 September 2020

2020-09-26T19:10:52Z

← Revisión anterior		Revisión del 19:10 26 sep 2020
Línea 7:		Línea 7:

	==Clinical Features==		==Clinical Features==
			[[File:Herpes zoster ophthalmicus.jpg\|thumb\|Herpes zoster ophthalmicus]]
	*Prodrome of [[headache]], malaise, photophobia, [[fever]]		*Prodrome of [[headache]], malaise, photophobia, [[fever]]
	*Unilateral [[eye pain\|pain]] or hypesthesia in V1 distribution		*Unilateral [[eye pain\|pain]] or hypesthesia in V1 distribution
Línea 14:		Línea 15:
	**Pseudodendrite (poorly staining mucous plaque with no epithelial erosion		**Pseudodendrite (poorly staining mucous plaque with no epithelial erosion
	***In contrast to [[HSV]] which has true dendrite with epithelial erosion and staining		***In contrast to [[HSV]] which has true dendrite with epithelial erosion and staining
	**Cell and flare ~~[[File:Herpes zoster ophthalmicus.jpg\|150px\|thumb]]~~		**Cell and flare

	==Differential Diagnosis==		==Differential Diagnosis==

Hoxbox: /* Clinical Features */

2019-12-18T11:09:56Z

Clinical Features

← Revisión anterior		Revisión del 11:09 18 dic 2019
Línea 14:		Línea 14:
	**Pseudodendrite (poorly staining mucous plaque with no epithelial erosion		**Pseudodendrite (poorly staining mucous plaque with no epithelial erosion
	***In contrast to [[HSV]] which has true dendrite with epithelial erosion and staining		***In contrast to [[HSV]] which has true dendrite with epithelial erosion and staining
	**Cell and flare		**Cell and flare [[File:Herpes zoster ophthalmicus.jpg\|150px\|thumb]]

	==Differential Diagnosis==		==Differential Diagnosis==
	{{Conjunctivitis DDX}}		{{Conjunctivitis DDX}}

Hoxbox: /* Disposition */

2019-12-16T11:30:14Z

Disposition

← Revisión anterior		Revisión del 11:30 16 dic 2019
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	==Disposition==		==Disposition==
			*Immunocompetent patient: Oral antiviral.
			*Immunocompromised patient: ”IV acyclovir and hospitalization is recommended. Neuroimaging is advised in patients with vision loss.”<ref>SAEM Clinical Image Series: A Case of a Painful Facial Rash. J Chan, et al. Aliem accessed Dec 16, 2019 available online at https://www.aliem.com/2019/12/saem-clinical-image-series-facial-rash/ </ref>

	==See Also==		==See Also==

ClaireLewis at 16:58, 5 October 2019

2019-10-05T16:58:56Z

← Revisión anterior		Revisión del 16:58 5 oct 2019
Línea 7:		Línea 7:

	==Clinical Features==		==Clinical Features==
	*Prodrome of headache, malaise, photophobia, fever		*Prodrome of [[headache]], malaise, photophobia, [[fever]]
	*Unilateral pain or hypesthesia in V1 distribution		*Unilateral [[eye pain\|pain]] or hypesthesia in V1 distribution
	*Hyperemic conjunctivitis, episcleritis, lid droop		*Hyperemic [[conjunctivitis]], [[episcleritis]], lid droop
			*Vesicular [[rash]] in V1 distribution
			*[[Slit-lamp exam]]:
			**Pseudodendrite (poorly staining mucous plaque with no epithelial erosion
			***In contrast to [[HSV]] which has true dendrite with epithelial erosion and staining
			**Cell and flare
	==Differential Diagnosis==		==Differential Diagnosis==
	{{Conjunctivitis DDX}}		{{Conjunctivitis DDX}}
Línea 19:		Línea 23:

	==Evaluation==		==Evaluation==
	*~~Zoster in distribution of V1~~		*Clinical
	*Slit-lamp exam:
	**Pseudodendrite (poorly staining mucous plaque with no epithelial erosion
	***In contrast to [[HSV]] which has true dendrite with epithelial erosion and staining
	**Cell and flare

	==Management==		==Management==
	*Cool compresses/lubrication drops		*Cool compresses/lubrication drops
	*Topical antibiotics to skin to prevent secondary infection		*Topical [[antibiotics]] to skin to prevent secondary infection
	*Antiviral therapy indicated for rash <1wk duration		*Antiviral therapy indicated for rash <1wk duration
	**[[Acyclovir]] IV 10mg/kg q8hrs x7-10 days<ref>Wills Eye Manual, 6th edition</ref> '''OR'''		**[[Acyclovir]] IV 10mg/kg q8hrs x7-10 days<ref>Wills Eye Manual, 6th edition</ref> '''OR'''
	**[[~~Famiciclovir~~]] 500mg PO q8hrs x14 days '''OR'''		**[[Famciclovir]] 500mg PO q8hrs x14 days '''OR'''
	**[[Valacyclovir]] 1g PO q8hrs		**[[Valacyclovir]] 1g PO q8hrs
	*Prevention of reactivation		*Prevention of reactivation

Kxl328: /* Background */

2018-11-01T03:04:27Z

Background

← Revisión anterior		Revisión del 03:04 1 nov 2018
Línea 3:		Línea 3:
	*50% of cases associated with ocular involvement		*50% of cases associated with ocular involvement
	**Highly suggested by vesicles at tip of nose (Hutchinson's sign)		**Highly suggested by vesicles at tip of nose (Hutchinson's sign)
			**Nasociliary branch of V1 innervates both the lateral/tip of nose as well as the cornea
	*Consider immunocompromise in patients <40yrs		*Consider immunocompromise in patients <40yrs

Mholtz at 03:43, 31 July 2017

2017-07-31T03:43:07Z

← Revisión anterior		Revisión del 03:43 31 jul 2017
Línea 25:		Línea 25:

	==Management==		==Management==
	#Cool compresses/lubrication drops		*Cool compresses/lubrication drops
	#Topical antibiotics to skin to prevent secondary infection		*Topical antibiotics to skin to prevent secondary infection
	~~#[[Acyclovir]]~~ indicated for rash <1wk duration		*Antiviral therapy indicated for rash <1wk duration
	#*~~Treatment -~~ [[~~acyclovir~~]] IV 10mg/kg q8hrs x7-10 days<ref>Wills Eye Manual, 6th edition</ref>		**[[Acyclovir]] IV 10mg/kg q8hrs x7-10 days<ref>Wills Eye Manual, 6th edition</ref> '''OR'''
	#*OR [[~~famiciclovir~~]] PO ~~500mg~~ q8hrs x14 days		**[[Famiciclovir]] 500mg PO q8hrs x14 days '''OR'''
	#*OR [[~~valacyclovir~~]] PO 1g q8hrs		**[[Valacyclovir]] 1g PO q8hrs
	#Prevention of reactivation		*Prevention of reactivation
	#*[[Acyclovir]] PO 500mg 5x per day		**[[Acyclovir]] PO 500mg 5x per day
	#Ophtho consultation regarding steroid use		*Ophtho consultation regarding steroid use

	==Disposition==		==Disposition==


	==See Also==		==See Also==