How to manage herpes zoster ophthalmicus

erpes zoster (shingles) is an infection caused by re-activation of the varicella zoster virus, which causes chickenpox.Primary infection usually happens in childhood.After the primary infection, the patient is immune to the virus, which then lies inactive in the dorsal root ganglia or cranial ganglia.Eventually, as the patient's natural immunity reduces as a result of ageing or disease, the virus can reactivate and spread to the skin, via the afferent nerves, to cause herpes zoster.By the time they are 40 years of age, the vast majority (99.6%) of individuals worldwide have antibodies to varicella zoster virus and are therefore at risk of herpes zoster. 1 About one-third of individuals will get herpes zoster in their lifetime.Herpes zoster can appear at any age, although there is a strong tendency for it to develop after 60 years of age due to natural weakening of the immune system.There has been a worldwide increase in the prevalence of herpes zoster.The reason for this is not known; however, with an ageing population, the incidence is likely to increase.The majority of individuals who get herpes zoster are otherwise healthy.However, it is more common in immunocompromised individuals (e.g., after chemotherapy, immunotherapy or oral steroids) or with some diseases (e.g., diabetes mellitus or cancer).In some regions, herpes zoster may signal underlying immunosuppression from HIV/AIDS, especially in young adults; these patients are also at risk of severe complications and systemic involvement.Recurrent attacks of herpes zoster are uncommon, but they are a feature of HIV/AIDS.