HERPES ZOSTER OPHTHALMICUS: CLINICAL SPECTRUM

Magdalena Natalia Nowak; Konrad Oskar Wiśniewski; Natalia Sara Kuśmierowska; Milena B. Polak; Dominika  Karolak; Grzegorz Słomkowski; Monika  Kuś; Tymoteusz  Białowąs; Kacper Cholewiński; Daria  Valipur Kolti

doi:10.31435/ijitss.2(50).2026.5430

Authors

Magdalena Natalia Nowak Cardinal Stefan Wyszynski University in Warsaw, Collegium Medicum, Warsaw, Poland https://orcid.org/0009-0002-1010-3364
Konrad Oskar Wiśniewski Cardinal Stefan Wyszynski University in Warsaw, Collegium Medicum, Warsaw, Poland https://orcid.org/0009-0007-1076-6471
Natalia Sara Kuśmierowska Medical University of Warsaw, Warsaw, Poland https://orcid.org/0009-0006-7572-0282
Milena B. Polak Medical University of Warsaw, Warsaw, Poland https://orcid.org/0009-0007-6148-5354
Dominika Karolak Medical University of Warsaw, Warsaw, Poland https://orcid.org/0009-0007-1131-9171
Grzegorz Słomkowski Medical University of Warsaw, Warsaw, Poland https://orcid.org/0009-0003-3742-8377
Monika Kuś Medical University of Warsaw, Warsaw, Poland https://orcid.org/0009-0009-6445-5593
Tymoteusz Białowąs Medical University of Warsaw, Warsaw, Poland https://orcid.org/0009-0001-0889-2635
Kacper Cholewiński Medical University of Warsaw, Warsaw, Poland https://orcid.org/0009-0004-7185-5310
Daria Valipur Kolti University Clinical Centre, Medical University of Warsaw, Warsaw, Poland https://orcid.org/0009-0005-9900-4419

DOI:

https://doi.org/10.31435/ijitss.2(50).2026.5430

Keywords:

Herpes Zoster Ophthalmicus, Varicella-Zoster Virus, Keratitis, Uveitis, Antiviral Therapy

Abstract

Objective: Herpes zoster ophthalmicus (HZO) is a severe manifestation of varicella-zoster virus reactivation affecting the ophthalmic branch of the trigeminal nerve. The aim of this review is to present the clinical spectrum of HZO and emphasize the importance of early diagnosis and treatment.

Methods: A narrative review of the literature concerning epidemiology, pathophysiology, and ocular manifestations of HZO was conducted. Published clinical studies and reviews describing ocular complications and therapeutic strategies were analyzed.

Results: HZO may involve multiple ocular structures, including eyelids, conjunctiva, cornea, uveal tract, sclera, retina, and optic nerve. The most common manifestations include blepharoconjunctivitis and keratitis, while severe complications may include uveitis, scleritis, acute retinal necrosis, optic neuritis, and cranial nerve palsies. Early antiviral therapy significantly reduces the risk of ocular complications and chronic disease.

Conclusions: Herpes zoster ophthalmicus presents with a broad spectrum of clinical manifestations that may lead to permanent visual impairment if untreated. Early recognition, prompt antiviral therapy, and appropriate ophthalmologic management are essential for improving patient outcomes. Preventive vaccination plays an important role in reducing the incidence of the disease.

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