DOI: 10.36347/sjams.2019.v07i08.058

Pages: 2921-2927

Background: Herpes zoster ophthalmicus (HZO) is a potentially sight-threatening and life-altering manifestation of varicella-zoster virus (VZV) reactivation involving the ophthalmic branch of the trigeminal nerve. While dermatological features are well characterised, the co-occurrence of neurological complications including post-herpetic neuralgia, cranial nerve palsies, meningitis, encephalitis, and cerebrovascular events adds significant morbidity and demands a multi-disciplinary clinical approach. Objectives: This study aimed to evaluate the clinical spectrum, neurological complications, treatment modalities, and short-term outcomes of HZO patients managed jointly by the Departments of Dermatology and Neurosurgery at Mamata Medical College and General Hospital, Khammam, Telangana, India, over a six-month period. Methods: A prospective observational study was conducted from January 2019 to June 2019. Thirty patients with clinically and virologically confirmed HZO were enrolled. Clinical parameters, ophthalmological findings, neurological assessments, treatment protocols, and follow-up outcomes were systematically recorded and analysed using descriptive and inferential statistics. Results: The study cohort comprised 30 patients (18 male, 12 female; mean age 58.6 ± 14.3 years). Neurological complications occurred in all 30 patients (100%), with post-herpetic neuralgia being the most frequent (46.7%), followed by cranial nerve palsy (26.7%), aseptic meningitis (13.3%), encephalitis (6.7%), cerebral vasculitis (3.3%), and ischaemic stroke (3.3%). Ocular involvement included keratitis (40%), uveitis (26.7%), and reduced visual acuity (33.3%). Valacyclovir was associated with significantly faster rash crusting (7.1 ± 1.3 vs 9.4 ± 1.8 days; p=0.012) compared to acyclovir. Conclusion: HZO carries a significant burden of neurological morbidity requiring coordinated dermatology-neurosurgery management. Early antiviral therapy, prompt neurological assessment, and vigilant fo