H. zoster Blepharitis

• Unilateral condition

Clinical Features

• Symptoms:
  • Systemic symptoms: fatigue, malaise and low-grade fever
  • Dermatomal pain involving the involved division of trigeminal nerve (CN V)
• Nummular or geographic areas of erythematous papules that evolve into vesicles on an erythematous base over several days, eventually become ulcerated, suppurated and crusted.

Management

• Moist compresses
• Topical antibiotics (avoid secondary infection)
• Oral antivirals within 72 hours of onset:
  • Reduces viral shedding
  • Decreases systemic dissemination of virus
  • Ameliorates incidence of most common ocular complications
  • No effect on post herpetic neuralgia