When herpes zoster ophthalmicus extends to the posterior segment of the eye, it can produce severe, sight-threatening complications that require urgent specialist evaluation and a specific management approach distinct from uncomplicated anterior disease.
This protocol applies to patients with HZO presenting with posterior segment complications, including:
Management involves systemic antiviral and steroid therapy — the specific route, agents, and full regimen depend on clinical severity and are set out in the complete protocol. Urgent referral to a retinal specialist is indicated.
Patients with posterior segment involvement will require management with systemic (IV or oral) antivirals and steroids and require urgent referral to a retinal specialist.
Posterior segment complications: optic neuritis, optic atrophy, retinitis, retinal necrosis, secondary glaucoma (due to trabeculitis).
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