👁️ Clinical Rounds: Herpes Zoster Ophthalmicus 🔬📚
This past week at My Eye Consultants, we encountered three patients with Herpes Zoster Ophthalmicus (HZO), a condition that optometry students and clinicians alike should recognize quickly.
Herpes Zoster (shingles) affects 3–5 per 1,000 people annually, with nearly a 30% lifetime risk. When the ophthalmic branch (V1) of the trigeminal nerve is involved, Herpes Zoster Ophthalmicus occurs, representing 10–25% of all shingles cases. What makes this so important? Ocular complications are seen in up to 50% of HZO patients — including keratitis, uveitis, retinitis, and potentially sight-threatening disease.
👉 Case highlight: One patient presented with Hutchinson’s sign (lesions at the tip/side of the nose, reflecting nasociliary nerve involvement). This clinical clue is a major predictor of ocular involvement, with 50–76% of patients developing corneal or intraocular pathology compared to ~30% without Hutchinson’s sign.
In this case, the patient exhibited epithelial corneal ulcers, stromal keratitis beneath the pupil, and endotheliitis. Immediate antiviral therapy was initiated.
💡 Key learning for optometry students:
Recognize Hutchinson’s sign as a red flag.
Know the systemic stats: 30% lifetime risk, 10–25% ophthalmic involvement, 50% complication rate.
Be aware that corneal, uveal, and retinal complications can develop rapidly and require prompt management.
👨⚕️ Dr. Luis W. Lu, MD and Dr. Andrew N. Lu, OD shared this case to emphasize the importance of early detection, swift treatment, and clinical vigilance in practice.
📍 Chandler, Gilbert, Mesa — Serving East Valley families with a father-and-son eye care team dedicated to education and patient care.
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myeyeconsultants.com | ☎ 480-590-0505
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