Ophthalmic Herpes Zoster

Cinical feature

• Herpes zoster involving the eye

Investigation

• COPAN swab from de-roofed blister
• If systemically unwell, consider blood culture
• Consider HIV testing

Infection Control

• Isolate with contact precautions
• Do not place patient in V34
• Pregnant staff should avoid caring for the patient

Infectious from 2 days before appearance of rash and until all lesions have crusted

Treatment

Discuss patient with ophthalmology

ACICLOVIR IV 10mg/kg 8 hourly

For obese patients (BMI ≥30kg/m²) dose according to adjusted body weight rather than ideal body weight (IBW)

Adjusted body weight = (0.4 x [total body weight – IBW] ) + IBW 

Dosing interval may require adjustment if CrCl <50ml/min - see BNF for further information

 

For patients showing a good response, consider IVOS to:

ACICLOVIR PO 800mg 5 times per day 

Duration: 5 days total (extend to 7 days total if converted to oral)