Herpes zoster keratitis is corneal inflammation caused by reactivation of varicella zoster virus in the ophthalmic branch of the trigeminal nerve. It usually occurs as part of shingles affecting the eye (herpes zoster ophthalmicus).
Clinical features
Patients often have a painful blistering rash on the forehead and eyelids on one side, followed by redness, pain, and blurred vision. Corneal involvement can range from surface punctate keratitis to stromal inflammation and scarring.
- May be associated with eyelid swelling and conjunctivitis
- Corneal sensitivity is often reduced
- Can lead to chronic dry eye and neurotrophic keratopathy
Treatment and follow-up
Early systemic antiviral tablets are important to limit viral replication and reduce complications. Long-term follow-up in a service such as general ophthalmology helps monitor for corneal scarring, raised eye pressure, and recurrent inflammation.
