Treatment of Herpes Zoster Ophthalmicus in Immunocompromised Patients or Disseminated Disease

When herpes zoster ophthalmicus occurs alongside disseminated herpes zoster or in a patient with immunocompromised status, the clinical situation calls for a distinct antiviral strategy beyond standard outpatient care.

Clinical scenario: This protocol addresses HZO in the context of disseminated herpes zoster or immunocompromised status — both of which significantly affect the choice and route of antiviral therapy.

Management in this setting involves intravenous antiviral therapy. The specific agent depends on the clinical circumstances — including how the disease has responded to prior treatment. The complete evidence-based regimen, with full selection criteria, is available in the structured protocol below.

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References

In disseminated HZ or in immunocompromised patients, IV acyclovir is indicated; if the disease is resistant to acyclovir, IV foscarnet may be considered.

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