Herpes zoster ophthalmicus: Difference between revisions
m (Rossdonaldson1 moved page Herpes Zoster Ophthalmicus to Herpes zoster ophthalmicus) |
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###In contrast to HSV which has true dendrite w/ epithelial erosion and staining | ###In contrast to HSV which has true dendrite w/ epithelial erosion and staining | ||
##Cell and flare | ##Cell and flare | ||
==Differential Diagnosis== | |||
{{Conjunctivitis DDX}} | |||
==Treatment== | ==Treatment== |
Revision as of 15:45, 26 January 2015
Background
- Occurs when VZV is reactivated in the ophthalmic division (V1) of trigeminal nerve
- 50% of cases associated with ocular involvement
- Highly suggested by vesicles at tip of nose (Hutchinson's sign)
- Consider immunocompromise in pts <40yrs
Clinical Features
- Prodrome of HA, malaise fever
- Unilateral pain or hypesthesia in V1 distribution
- Hyperemic conjunctivitis, episcleritis, lid droop
Diagnosis
- Zoster in distribution of V1
- Slit-lamp exam:
- Pseudodendrite (poorly staining mucous plaque w/ no epithelial erosion
- In contrast to HSV which has true dendrite w/ epithelial erosion and staining
- Cell and flare
- Pseudodendrite (poorly staining mucous plaque w/ no epithelial erosion
Differential Diagnosis
Conjunctivitis Types
Treatment
- Cool compresses/lubrication drops
- Topical antibiotics to skin to prevent secondary infection
- Acyclovir
- Indicated for rash <1wk duration
- 800mg 5x/day x 7-10d
- Ophtho consultation regarding steroid use
Source
- UpToDate
- Tintinalli