What is the treatment of herpes zoster ophthalmicus?
Treatment approach
Management centres on oral antiviral therapy initiated early after rash onset, alongside supportive topical treatment — the full protocol specifies which agents to use, in what sequence, and over what duration.
Complete drug selection, dosing schedules, and duration are in the structured protocol below.
References
- Many studies have found oral acyclovir (as well as famciclovir (Tyring et.al., 1995) and valacyclovir (valaciclovir) (Colin et.al., 2000) started within 48-72 hours of rash onset to be safe and effective in treating active disease and preventing post-herpetic neuralgia.
- The standard dosage of acyclovir for herpes zoster infections in adults is 800mg five times a day (at approximately 4 hourly intervals).
- Treatment should continue for 7-14 days.
- The standard treatment regimen for valacyclovir is 1000 mg, three times per day for 7-14 days, and for famciclovir, it is 500 mg per day for 7 days.
- Ocular lubricants/artificial tears, topical NSAIDs.
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