Herpes zoster ophthalmicus is a severe eyelid skin disease caused by infection of the trigeminal nerve's semilunar ganglion or one of its branches with the varicella-zoster virus.

bubble_chart Etiology

Herpes zoster ophthalmicus is a severe eyelid skin disease caused by infection of the trigeminal nerve's semilunar ganglion or one of its branches with the varicella-zoster virus. Patients undergoing radiation therapy or immunosuppressive treatment are more susceptible to this condition. After infection, lifelong immunity is typically acquired, and recurrence is rare.

bubble_chart Diagnosis

1. Site of onset: It often occurs in the first branch (ophthalmic branch) of the trigeminal nerve, distributed in the hairy scalp, forehead, and skin of the upper eyelid; sometimes it also affects the second branch, with lesions distributed in the lower eyelid, cheek, and upper lip. Its characteristic is that it only affects one side, stopping at the midline of the forehead to form a distinct boundary.
2. Subjective symptoms: In the initial stage [first stage] of the disease, there is severe neuralgia, photophobia, tearing, etc., in the distribution area of the trigeminal nerve.
3. Signs: A few days after the onset, skin redness and swelling appear, accompanied by clusters of numerous transparent herpes of varying sizes, arranged in a band-like pattern. Initially, the blisters are colorless and transparent, then become turbid and purulent, forming scabs that fall off within a few weeks. Due to the involvement of the dermis, permanent scars are left. It often complicates keratitis and iridocyclitis, affecting vision, and occasionally causes ocular muscle paralysis. In addition, severe cases may be accompanied by systemic symptoms such as fever, chills, malaise, or local lymphadenopathy and tenderness.

bubble_chart Treatment Measures

1. Rest in bed and eat easily digestible food.
2. Apply 1% Chinese Gentian Violet locally, or sprinkle Talc powder.
3. Sedatives and analgesics can be given when the pain is severe.
4. For severe cases, placental globulin, gamma globulin, and vitamin B12 can be administered intramuscularly to enhance the body's resistance.
5. Convalescent stage whole blood or serum should be given intramuscularly, 10 ml each time, which can have a significant effect.
6. If complicated by keratitis or iridocyclitis, apply 0.1~0.2% idoxuridine (IDU) locally, along with mydriatics and hot compresses.
7. If necessary, appropriate antibiotics and corticosteroids can be added.