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Zoster Ophthalmicus


Zoster is the result of reactivation of Varicella zoster virus, which persists in nerve ganglion cells after the primary infection. Ocular complications are likely when the virus involves the ophthalmic division of the trigeminal nerve, particularly when vesicles on the side or the tip of the nose indicate involvement of the nasociliary branch (Hutchinson’s sign). Often the peri-orbital tissue is so swollen that the lids are closed. The pain may be severe. Ocular complications include keratitis, conjunctivitis, uveitis, ocular muscle palsies, and ulceration, scarring and even necrosis of the lid.




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