Herpes zoster ophthalmicus at a tertiary health facility, South-western Nigeria: Clinical presentations and outcome

Abstract

Herpes zoster ophthalmicus is a neurocutaneous disease caused by the human alpha herpes virus Type 3 and it is characterized by reactivation of dormant varicella-zoster virus lying within the trigeminal ganglia. The objective of this study was to describe the clinical presentation and management outcome of patients with herpes zoster ophthalmicus in a tertiary health facility. This was a retrospective study of patients with herpes zoster ophthalmicus managed at the Eye Clinic of a tertiary health facility in the South-western part of Nigeria over eight years. There were 17 patients, comprising five males and the mean age at presentation was 54.9±13.7 years. Seven (41.2%) patients were seropositive for the Human Immunodeficiency Virus (HIV) while nine (52.9%) patients had corneal involvement. Fifteen (88.2%) patients had involvement of the first branch of the trigeminal nerve (V1), and one (5.9%) patient each had involvement of the second branch of the trigeminal nerve (V2) and the first two branches of the trigeminal nerve (V1 and V2). All the patients were managed with oral and topical antiviral medications. Ten patients (58.8%) developed postherpetic neuralgia. In conclusion, Herpes zoster ophthalmicus is strongly associated with HIV seropositivity and older age and a significant proportion of patients develop post-herpetic neuralgia necessitating long term management.

Keywords

• herpes simplex
• herpes zoster ophthalmicus
• human immunodeficiency virus
• postherpetic neuralgia