Herpes zoster ophthalmic, complication of the herpes zoster

Abstract

Herpes zoster comes from the Latin word herpes and the Greek word zoster meaning belt.  varicella zoster virus belongs to the family Herpesviridae, subfamily Alfaherpesvirinae; it is an icosahedral double-banded DNA virus and exclusively infects humans. Primoinfection mainly affects children, subsequently the patient becomes immune to the virus, so it remains inactive in the dorsal or cranial root ganglia. The main risk factor is age, since as age increases, cellular immunity decreases. Herpes zoster ophthalmicus is a severe variant of herpes zoster and occurs in 20% of cases. It does not always involve the eye, however, there is a 50% risk of ocular disease if the first division of the fifth cranial or trigeminal nerve is affected. Hutchinson's sign is a predictor, this given that it is characterized by the presence of a vesicle in the nasal tip, and this represents the dermatome of the nasociliary branch of the ophthalmic nerve. Oral antivirals are recommended for 7 to 10 days such as acyclovir, valacyclovir or famciclovir. In case the patient presents Hutchinson's sign, a control appointment should be made 1 to 2 weeks after the diagnosis and in case the patient presents red eye, it should be reevaluated before 48 hours, but if there is a decrease in visual acuity, it should be reevaluated before 24 hours.