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Herpes Zoster Ophthalmicus Review and Prevention

Davis, Andrew R. M.D.; Sheppard, John M.D.

doi: 10.1097/ICL.0000000000000591
Review Article

Abstract: Varicella-zoster virus (VZV) is the etiologic agent of both chickenpox and Herpes zoster (HZ). In the United States, there are around one million cases of HZ per year. Ten percent of HZ cases are subtyped as herpes zoster ophthalmicus (HZO) specifically and involve the V1 distribution. Herpes zoster ophthalmicus is a significant cause of blindness in the United States. This article will provide a basic overview of VZV, HZ, and HZO with a focus on preventative measures in an effort to prevent blindness through improving clinician awareness and education. The differences in clinical effectiveness and duration of effectiveness of the live (Zostavax) and recombinant vaccines (Shingrix) are illustrated. There is now a trend toward using the recombinant vaccine as recommended by the Advisory Committee for Immunization Practices (ACIP) for healthy adults 50 or older.

Department of Ophthalmology, Eastern Virginia Medical School, Norfolk, VA.

Address correspondence to John Sheppard, M.D., Virginia Eye Consultants/Cincinnati Eye Institute, 241 Corporate Boulevard, Norfolk, VA 23502; e-mail:

J. Sheppard (Novartis, Bausch+Lomb, Allergan), The remaining author has no conflicts of interest to disclose.

Accepted January 12, 2019

© 2019 Contact Lens Association of Ophthalmologists, Inc.