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admin 30.09.2014

Reactivation of varicella-zoster virus (VZV) that has remained dormant within dorsal root ganglia, often for decades after the patient’s initial exposure to the virus in the form of varicella (chickenpox), results in herpes zoster (shingles).
Is caused by VZV infection of the head and neck involving the facial nerve (seventh cranial nerve). Doctors should be alert to sight threatening eye complications if skin lesions are located in the dermatome of the nasociliary nerve. The disease is potentially serious and may result in severe and lasting pain, particularly in elderly patients.
It becomes increasingly common with age, affecting about one-third of patients aged over 40.


The pain may be continuous and burning with increased sensitivity in the affected areas or a spasmodic shooting type of pain. Herpes zoster can result in chickenpox (varicella) in those who have never developed primary immunity, both from virus in the lesions and in some instances the nose and throat. Although it is usually a self-limiting dermatomal rash, herpes zoster can be far more serious; in addition, acute cases often lead to postherpetic neuralgia. Moreover, without antiviral treatment, about half of all patients will develop various eye disorders. Conjunctivitis, for example, is seen in nearly all of ophthalmic zoster patients with ocular involvement.


If these latter disorders are not diagnosed and treated adequately the patient's sight may become permanently affected.
Moreover, a decreased corneal sensitivity combined with inadequate blinking may lead to severe problems with dry eyes and subsequent corneal complications (neurotrophic ulceration, exposure keratopathy and secondary bacterial infection).



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