Diferencia entre revisiones de «Herpes zoster ophthalmicus»
m (moved HSV Ophthalmic to Herpes Zoster Ophthalmicus) |
Sin resumen de edición |
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| Línea 1: | Línea 1: | ||
==Background== | |||
*Herpes zoster (HZV) ophthalmicus | |||
*Occurs when the varicella-zoster virus is reactivated in the ophthalmic division of the trigeminal nerve | |||
*10-25% of all zoster cases | |||
*Most cases involve skin only, but serious ocular involvement can occur (if involves nasociliary branch) | |||
**Hutchinson’s sign = pustules at tip of the nose | |||
***Mild specificity for ocular involvement | |||
***NOT sensitive for ocular involvement | |||
==Diagnosis== | ==Diagnosis== | ||
corneal dedrite | #Rash in distribution | ||
#If corneal invovement | |||
##Corneal dedrite on fluorescein stain | |||
###Appear branching or ‘‘medusa-like’’ pattern with tapered ends | |||
####In contrast to HSV dendrites, which have terminal bulbs | |||
==Treatment== | ==Treatment== | ||
# | #No corneal involvement | ||
# | ##Topical antibiotics may prevent secondary infection | ||
##Cool compresses/lubrication drops | |||
##Ophtho followup (within 24hrs if any ocular involvement) | |||
#Corneal involvement | |||
##Artificial tears (preservative-free) Q1-2 hrs | |||
##Ocular lubricant ointment QHS | |||
##Consult ophtho regarding | |||
###Systemic or topical antiviral agents | |||
###Topical steroids (caution; only in consultation) | |||
==Source== | |||
[[Category:ID]] | [[Category:ID]] | ||
[[Category:Ophtho]] | [[Category:Ophtho]] | ||
Revisión del 21:35 30 jul 2011
Background
- Herpes zoster (HZV) ophthalmicus
- Occurs when the varicella-zoster virus is reactivated in the ophthalmic division of the trigeminal nerve
- 10-25% of all zoster cases
- Most cases involve skin only, but serious ocular involvement can occur (if involves nasociliary branch)
- Hutchinson’s sign = pustules at tip of the nose
- Mild specificity for ocular involvement
- NOT sensitive for ocular involvement
- Hutchinson’s sign = pustules at tip of the nose
Diagnosis
- Rash in distribution
- If corneal invovement
- Corneal dedrite on fluorescein stain
- Appear branching or ‘‘medusa-like’’ pattern with tapered ends
- In contrast to HSV dendrites, which have terminal bulbs
- Appear branching or ‘‘medusa-like’’ pattern with tapered ends
- Corneal dedrite on fluorescein stain
Treatment
- No corneal involvement
- Topical antibiotics may prevent secondary infection
- Cool compresses/lubrication drops
- Ophtho followup (within 24hrs if any ocular involvement)
- Corneal involvement
- Artificial tears (preservative-free) Q1-2 hrs
- Ocular lubricant ointment QHS
- Consult ophtho regarding
- Systemic or topical antiviral agents
- Topical steroids (caution; only in consultation)