What are the symptoms of herpes zoster (shingles) ophthalmicus (HZO)?

Updated: Feb 11, 2021
  • Author: Camila K Janniger, MD; Chief Editor: Dirk M Elston, MD  more...
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Aggressive treatment and follow-up monitoring are required for HZO because of the possibility of eye involvement, which occurs in about 50% of HZO patients. Traditionally, nasociliary branch involvement, characterized by vesicles at the tip of the nose, has indicated that eye involvement is present or imminent (the Hutchinson rule). This rule is now being disputed, with some experts claiming that eye and nasociliary branch involvement can be present without such vesiculation. In our experience, eye lesions are rare in the absence of distal nose lesions.

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