Herpes Zoster Ophthalmicus: A Teaching Case Report

Kent Nguyen, OD
Joseph Gallagher, OD, FAAO
Dorothy Hitchmoth, OD, FAAO, Diplom



Herpes zoster ophthalmicus (HZO) is a disease that occurs when the ophthalmic
division of the trigeminal nerve is impaired as a result of reactivation of
the varicella-zoster virus. HZO develops in 10-20% of patients who experience
reactivation of zoster in the fifth cranial nerve dermatome. The patient in this
teaching case report developed neurotrophic keratitis as a result of both HZO and
diabetic neuropathy of V1. This teaching case illustrates many of the classic signs
and symptoms of HZO and discusses appropriate treatment, management and
patient education.

Key Words:  herpes zoster ophthalmicus, neurotrophic keratitis, diabetes mellitus,
antiviral, Hutchinson’s sign, Zostavax

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