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The Clinical Profile and Ocular Manifestations of Herpes Zoster Ophthalmicus- A Hospital Based Study

Received: 28 January 2019     Accepted: 22 March 2019     Published: 18 April 2019
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Abstract

Background: Herpes Zoster Ophthalmicus (HZO) occurs due to reactivation of latent varicella zoster virus within the gasserian ganglion involving the ophthalmic division of the trigeminal nerve. HZO often has a chronic course with significant ocular morbidity as eye is considered potentially serious of all sites of herpes zoster owing to its delicate nature. Purpose:1. To study the mode of presentation, ocular manifestations and complications of herpes zoster ophthalmicus (HZO) 2. To analyse the predisposing factors for the development of HZO. Materials and Methods: A prospective clinical study was done in 20 patients who were clinically diagnosed with HZO in the outpatient department of ophthalmology over a period of one year. They were subjected to a detailed general and ocular examination and were treated medically with close follow up. Result: Advancing age was the most common risk factor. Acute neuralgia was the commonest presenting symptom (75%). Ocular involvement was seen in 16 patients with no bilaterality. Conjunctiva (60%) was the most common ocular structure involved followed by Cornea (45%). Anterior uveitis (20%) was complicated by haemorrhagic uveitis and orbital apex syndrome with total external ophthalmoplegia. Post herpetic neuralgia was the commonest complication seen. Conclusion: The potential manifestations of HZO are myriad. Development of serious inflammatory complications was associated with delay in therapy. Hence timely diagnosis and management are critical in limiting ocular morbidity

Published in International Journal of Ophthalmology & Visual Science (Volume 4, Issue 1)
DOI 10.11648/j.ijovs.20190401.14
Page(s) 19-23
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2019. Published by Science Publishing Group

Keywords

Herpes Zoster Ophthalmicus (HZO), Acyclovir, Orbital Apex Syndrome, Post Herpetic Neuralgia

References
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[2] Wilson FI. Varicella and Herpes Zoster ophthalmicus. Chap. 25 In : Tabbara K, Hyndiuk R eds. Infections of the eye 2nd edition. ( Bosten: Little, Brown, 1996):387-400.
[3] Deborah Pavan-Langston. Herpes Zoster Ophthalmicus. Neurology 1995; 45(suppl 8): S50-S51.
[4] Ragozzino MW, Melton LJ 3d, Kurland LT, Chu CP, Perry HO. Population-based study of herpes zoster and its sequelae. Medicine. 1982; 61:310–6.
[5] Liesegang TJ. Herpes Zoster Ophthalmicus. Ophthalmology 2008; 115: S3-S12.
[6] Thomas Catron, MD and H. Gene Hern, MD, West J Emerg Med. 2008 Aug; 9(3): 174–176.
[7] Deborah Pavan-Langston. Viral diseases of the ocular anterior segment. Chap 14. In: Foster CS., Azar DT., Dohlman CH.eds. Smolin and Thoft’s. The cornea. Scientific foundations and clinical practice. 4th edn. (Philadelphia: Lippincott Williams and Wilkins 2005); p297-397.
[8] Thomas SL, Hall AJ. What does epidemiology tell us about risk factors for herpes zoster? Lancet Infect Dis 2004; 4(1):26-33.
[9] Buchbinder SP, Katz MH, Hessol NA, et al. Herpes zoster and human immunodefciency virus infection. J Infect Dis 1992; 166:1153-1156.
[10] Evaluation and Management of Herpes Zoster Ophthalmicus - SAAD SHAIKH, M. D., and CHRISTOPHER N. TA, M. D., Stanford University Medical Center, Stanford, California Am Fam Physician. 2002 Nov 1; 66(9):1723-1730.
[11] Colin J, Prisant O, Cochener B, et al. Comparison of the efficacy and safety of valacyclovir and acyclovir for the treatment of herpes zoster ophthalmicus. Ophthalmology 2000; 107: 1507-1511.
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[15] Ghaznawi N, Virdi A, Dayan A, Hammersmith KM, Rapuano CJ, Laibson PR, Cohen EJ (2011) Herpes zoster ophthalmicus: comparison of disease in patients 60 years and older versus younger than 60 years. Ophthalmology 118:2242–2250.
[16] Borkar DS, Tham VM, Esterberg E, Ray KJ, Vinoya AC, Parker JV, Uchida A, Acharya NR (2013) Incidence of herpes zoster ophthalmicus: results from the Pacific ocular inflammation study. Ophthalmology 120:451–456.
[17] Malik LM, Azfar NA, Khan AR, et al. Herpes zoster in children. J Pak Assoc Dermatologists 2013; 23(3):267-271.
[18] Prabhu S, Sripathi H, Gupta S, et al. Childhood herpes zoster: a clustering of ten cases. Indian J Dematol 2009; 54(1):62-64
[19] Bayu S, Alemayehu W. Clinical Profile of Herpes zoster ophthalmicus in Ethiopians. Clin Infect Dis. 1997; 24:1256-60.
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    Prathibha Shanthaveerappa, Remya Joseph Parappallil. (2019). The Clinical Profile and Ocular Manifestations of Herpes Zoster Ophthalmicus- A Hospital Based Study. International Journal of Ophthalmology & Visual Science, 4(1), 19-23. https://doi.org/10.11648/j.ijovs.20190401.14

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    ACS Style

    Prathibha Shanthaveerappa; Remya Joseph Parappallil. The Clinical Profile and Ocular Manifestations of Herpes Zoster Ophthalmicus- A Hospital Based Study. Int. J. Ophthalmol. Vis. Sci. 2019, 4(1), 19-23. doi: 10.11648/j.ijovs.20190401.14

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    AMA Style

    Prathibha Shanthaveerappa, Remya Joseph Parappallil. The Clinical Profile and Ocular Manifestations of Herpes Zoster Ophthalmicus- A Hospital Based Study. Int J Ophthalmol Vis Sci. 2019;4(1):19-23. doi: 10.11648/j.ijovs.20190401.14

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  • @article{10.11648/j.ijovs.20190401.14,
      author = {Prathibha Shanthaveerappa and Remya Joseph Parappallil},
      title = {The Clinical Profile and Ocular Manifestations of Herpes Zoster Ophthalmicus- A Hospital Based Study},
      journal = {International Journal of Ophthalmology & Visual Science},
      volume = {4},
      number = {1},
      pages = {19-23},
      doi = {10.11648/j.ijovs.20190401.14},
      url = {https://doi.org/10.11648/j.ijovs.20190401.14},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijovs.20190401.14},
      abstract = {Background: Herpes Zoster Ophthalmicus (HZO) occurs due to reactivation of latent varicella zoster virus within the gasserian ganglion involving the ophthalmic division of the trigeminal nerve. HZO often has a chronic course with significant ocular morbidity as eye is considered potentially serious of all sites of herpes zoster owing to its delicate nature. Purpose:1. To study the mode of presentation, ocular manifestations and complications of herpes zoster ophthalmicus (HZO) 2. To analyse the predisposing factors for the development of HZO. Materials and Methods: A prospective clinical study was done in 20 patients who were clinically diagnosed with HZO in the outpatient department of ophthalmology over a period of one year. They were subjected to a detailed general and ocular examination and were treated medically with close follow up. Result: Advancing age was the most common risk factor. Acute neuralgia was the commonest presenting symptom (75%). Ocular involvement was seen in 16 patients with no bilaterality. Conjunctiva (60%) was the most common ocular structure involved followed by Cornea (45%). Anterior uveitis (20%) was complicated by haemorrhagic uveitis and orbital apex syndrome with total external ophthalmoplegia. Post herpetic neuralgia was the commonest complication seen. Conclusion: The potential manifestations of HZO are myriad. Development of serious inflammatory complications was associated with delay in therapy. Hence timely diagnosis and management are critical in limiting ocular morbidity},
     year = {2019}
    }
    

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    T1  - The Clinical Profile and Ocular Manifestations of Herpes Zoster Ophthalmicus- A Hospital Based Study
    AU  - Prathibha Shanthaveerappa
    AU  - Remya Joseph Parappallil
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    T2  - International Journal of Ophthalmology & Visual Science
    JF  - International Journal of Ophthalmology & Visual Science
    JO  - International Journal of Ophthalmology & Visual Science
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    PB  - Science Publishing Group
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    AB  - Background: Herpes Zoster Ophthalmicus (HZO) occurs due to reactivation of latent varicella zoster virus within the gasserian ganglion involving the ophthalmic division of the trigeminal nerve. HZO often has a chronic course with significant ocular morbidity as eye is considered potentially serious of all sites of herpes zoster owing to its delicate nature. Purpose:1. To study the mode of presentation, ocular manifestations and complications of herpes zoster ophthalmicus (HZO) 2. To analyse the predisposing factors for the development of HZO. Materials and Methods: A prospective clinical study was done in 20 patients who were clinically diagnosed with HZO in the outpatient department of ophthalmology over a period of one year. They were subjected to a detailed general and ocular examination and were treated medically with close follow up. Result: Advancing age was the most common risk factor. Acute neuralgia was the commonest presenting symptom (75%). Ocular involvement was seen in 16 patients with no bilaterality. Conjunctiva (60%) was the most common ocular structure involved followed by Cornea (45%). Anterior uveitis (20%) was complicated by haemorrhagic uveitis and orbital apex syndrome with total external ophthalmoplegia. Post herpetic neuralgia was the commonest complication seen. Conclusion: The potential manifestations of HZO are myriad. Development of serious inflammatory complications was associated with delay in therapy. Hence timely diagnosis and management are critical in limiting ocular morbidity
    VL  - 4
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Author Information
  • Department of Ophthalmology, Rajarajeswari Medical College and Hospital, Rajiv Gandhi University of Health And Sciences, Bangalore, India

  • Department of Ophthalmology, Rajarajeswari Medical College and Hospital, Rajiv Gandhi University of Health And Sciences, Bangalore, India

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