2015, Number 1
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ABSTRACTIntroduction: the initial infection by the virus of the varicella-zoster produces an exanthematous acute illness (varicella). A few months later the herpes zoster is developed because of a reactivation of the latent endogenous virus. The area innervated by the trigeminal nerve is the second taking in consideration its frequency. When the illness affects the first branch of the nerve, receives the name ophthalmic herpes zoster and it is very important because it is very dangerous for the eye.
Objective: to show the clinical manifestations evidence, complications and ophthalmic sequels in a patient with an ophthalmic herpes zoster diagnosis.
Case Presentation: a male patient of 75 years old with personal medical records of varicella in the childhood, he goes to outpatient service because of lacrimation, photophobia and great palpebral edema in his right eye, accompanied by clear watery vesicles and scabs in skin of the forehead and nose. The ophthalmic exam evidences severe ciliary and conjunctival injection, dendritic keratitis, corneal endothelial plaques and positive Hutchinson's sign. It was diagnosed as complicated herpes zoster ophthalmicus with acute uveitis that left as a sequel a neurotropic keratitis and dry eyes. It was indicated, previous information to the patient, treatment with acyclovir, prednisolone, homatropin, artificial tears and multivitamins. It was carried out the differential diagnosis with illnesses that affect skin and mucous, especially the conjunctive one, with lesions to blister as cicatrizal pemphigoid, Stevens-Johnson syndrome and herpes simplex keratitis.
Conclusions: the herpes zoster ophthalmicus is an important cause of ocular morbidity due to the sequels like the neurotropic keratitis and dry eyes, with the consequent damage to the ocular surface.
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