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Acta Ophthalmol Scand. 2003 Jun;81(3):216-20.

Visual prognosis in immunocompetent patients with herpes zoster ophthalmicus.

Author information

1
Department of Ophthalmology, VU University Medical Centre, Amsterdam, The Netherlands. mjw.zaal@vumc.nl

Abstract

PURPOSE:

To determine the normal spectrum of ocular complications and associated visual outcome in patients with herpes zoster ophthalmicus.

METHODS:

This prospective observational cohort study included 73 immunocompetent adults with herpes zoster ophthalmicus, referred by their general practitioners within 7 days of skin rash onset. The follow-up period was 6 months. All patients received a 7-14-day course of systemic aciclovir treatment combined with longterm application of a lubricating ophthalmic ointment as long as the corneal epithelium was affected. Topical corticosteroids were strictly avoided in the acute phase of ocular disease. Acquired visual loss scores at 1, 2 and 6 months were based on best corrected visual acuity (BCVA) level and evaluation of the ophthalmological history and findings.

RESULTS:

Ophthalmic herpes zoster led to a variety of transient inflammatory reactions within the anterior eye segment of the involved side in 46 patients (63%), but did not seriously compromise their ultimate visual outcome. Mild to moderate visual loss, with corrected VA between 0.3 and 0.8, was found in 17 patients at 1 month (23%), in 10 patients at 2 months (14%) and in seven patients at 6 months follow-up (10%). None of the patients developed visual loss with a corrected VA of less than 0.3.

CONCLUSION:

Functional vision was retained in all ophthalmic zoster patients referred to the ophthalmologist in the acute phase of the disease by vigorous antiviral treatment and adequate prevention of corneal exposure.

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