Herpes Zoster Ophthalmicus

Key history
Key examination
Initial management
Referral

Key history

• Time since incident
• Vision
• Systemic illness e.g. HIV, systemically unwell

Key examination

DO

Visual acuity in both eyes.

LOOK FOR

• Extent of rash – does it extend to the tip of nose, increasing risk of eye involvement
• Redness
• Corneal clarity
• Pupil size and reaction

Initial management

• Acyclovir 800mg orally 5x/day for 7-10 days
• Amitriptyline 25mg orally at night x 90 days minimum
• Paracetamol Codeine, 2 tablets orally 6 hourly as needed
• Potassium permanganate soaks twice daily (is available) followed by
• Silver Sulphadiazine 1% ointment to skin twice daily

Referral = Semi urgent – by phone during the day