Healthcare and Medicine Reference
HZO are related with: viral spread, nerve damage, ischaemic vasculitis,
and infl ammatory granulomatous reaction (Sanjay et al. 2011). They can
clinically be divided into three phases:
1) Acute phase: which resolves within 4 wk.
2) Chronic phase: which persists for years.
3) Relapsing phase: the lesions appear to be controlled, but can appear
The management of herpes zoster involves a multidisciplinary approach
aiming to reduce complications and morbidity. Patients with HZO are
referred to ophthalmologists for prevention or treatment of its potential
complications. Without prompt detection and treatment, HZO can lead to
substantial visual disability
Clinical Features: Symptoms and Signs
The main signs could be the presence of corneal lesions including punctate
epithelial keratitis (multiple peripheral lesions), micro-dendritic ulcers
(unlike the dendritic ulcers of HSV, they are peripheral, broader, more
plaque-like, and a more stellate than dendritic shape), nummular keratitis,
and disciform keratitis. Other ocular complications include: uveitis,
necrotizing retinitis, and cranial nerve palsies related with the eye.
Finally, the Epstein-Barr virus is a member of the family Herpesviridae
and is a common cause of lifelong infection in humans. Keratitis may
be unilateral or bilateral with onset in 1 to 4 wk after acute infectious
mononucleosis (IM). The epithelial keratitis is self-limited, and rarely
stromal keratitis may develop. Its main clinical features are irritation,
watering of eyes, photofobia, and blurred vision.
NON INFECTIOUS ULCERATIVE KERATITIS
Non infectious ulcerative keratitis or interstitial keratitis refers to a non-
ulcerative and non suppurated infl ammation of the central corneal stroma,
often with subsequent vascularization. It is a signifi cant cause of visual
impairment. It can be associated with bacterial pathogens, viral infection,
and parasitic infestations, or also related to immunologic factors, and may
arise without identifi able antecedent illness.
The corneal changes depend on the stage or duration of the disease.
In general, the epithelium is intact, although it may often be oedematous.
Depending on the severity, the entire process may remain localized in the
periphery or move centrally. The diagnosis of the cause of interstitial keratitis
must rely largely on the history, ocular as well systemic examination.