Clinical Characteristics, Visual Outcome and Predictive Factors of Ocular Involvement in Patients with Herpes Zoster Ophthalmicus in Thailand: A 10-Year Study.

PURPOSE: To evaluate the clinical characteristics, visual outcome, and predictive factors of ocular involvement in patients with herpes zoster ophthalmicus (HZO) in Thailand.

METHODS

A 10-year retrospective study.

RESULTS

A total of 199 patients were enrolled, with a mean age of 55.51 ± 19.29 years. Headache was the most common prodromal symptom, reported in 14.07% of the patients. The most frequent ocular symptom was eye redness (40.70%), followed by eye pain or irritation (32.66%). Overall, the visual outcome was favorable, with a median final best-corrected visual acuity (BCVA) of 20/25. However, age ≥ 60 years (p = 0.006) and nasociliary nerve involvement (p = 0.039) were both significantly associated with visual loss. Ocular involvement in HZO was significantly associated with the presenting symptom of eye redness (p < 0.001).

CONCLUSION

Conjunctival involvement was the most common ocular finding in patients with HZO. While most patients achieved good visual outcome following treatment, age ≥ 60 years and nasociliary nerve involvement appear to be strong predictors of visual loss, highlighting the need for closer monitoring in these high-risk groups. Eye redness may serve as a useful clinical indicator, prompting general practitioners to refer patients for ophthalmic evaluation.