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Herpes zoster ophthalmicus
Make it clearer
Herpes zoster ophthalmicus happens when the shingles virus affects the ophthalmic division of the trigeminal nerve, the nerve of the face, whose first branch carries sensation from the forehead, the eyelid and the nose. Having this diagnosis does not necessarily mean the eye is involved, but that happens in about half of cases.
The virus is the same one that causes chickenpox. After that infection it does not go away: it stays asleep inside the trigeminal ganglion, a cluster of nerve cell bodies. When cell-mediated immunity drops, the virus wakes up and moves. The virus travels down the nerve itself and comes out through the skin it supplies, where the painful vesicles appear on the forehead, the eyelid and the nose.
There is one detail that matters: if lesions appear on the tip of the nose, what is called the Hutchinson sign, the nasociliary branch is involved and the risk to the eye is higher.
In brief
Herpes zoster ophthalmicus occurs when the virus affects the ophthalmic division of the trigeminal nerve; eye disease is present in about half of cases.
The virus stays latent in the trigeminal ganglion after chickenpox; when cell-mediated immunity declines it reactivates and travels along the axons, with a painful vesicular rash on the forehead and eyelid.
It travels along the nerve's cable and erupts in the skin it supplies.
Lesions on the tip of the nose, the Hutchinson sign, point to nasociliary involvement and a higher risk to the eye.
Sources (1)
- National Center for Biotechnology Information, StatPearls PublishingHerpes Zoster Ophthalmicus, StatPearlsPublished
This page explains the topic in general terms; it does not tell anyone what treatment to follow.
Updated