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Early‐ and late‐stage ocular complications of herpes zoster ophthalmicus in rural South Africa
Author(s) -
Schaftenaar Erik,
Meenken Christina,
Baarsma G. Seerp,
McIntyre James A.,
Verjans Georges M. G. M.,
Peters Remco P. H.
Publication year - 2016
Publication title -
tropical medicine and international health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.056
H-Index - 114
eISSN - 1365-3156
pISSN - 1360-2276
DOI - 10.1111/tmi.12654
Subject(s) - medicine , herpes zoster ophthalmicus , photophobia , uveitis , keratitis , outpatient clinic , stage (stratigraphy) , ophthalmology , blindness , presentation (obstetrics) , visual acuity , dermatology , surgery , pediatrics , optometry , paleontology , biology
Objectives To describe the spectrum of ocular complications of herpes zoster ophthalmicus ( HZO ) in rural South Africa. Methods Patients presenting with visual complaints and active or healed HZO at the ophthalmology outpatient department of three hospitals in rural South Africa were included in this study. Demographic and clinical data were collected, and HIV status was determined for all participants. Results Forty‐eight patients were included, and 81% were HIV infected. Poor vision was reported by 94% of patients, painful eye by 79% and photophobia by 63%. A diverse spectrum of ocular complications was observed with corneal inflammation and opacification in 77% followed by anterior uveitis in 65%. The majority (65%) presented with late‐stage ocular complications associated with irreversible loss of vision whereas early‐stage complications, such as punctate epithelial keratitis and anterior uveitis, were less common. Blindness of the affected eye was observed in 68% of patients with late‐stage complications. There was a considerable delay between onset of symptoms and first presentation to the ophthalmology outpatient department (median time 35 days; range 1–2500 days), and longer delay was associated with late‐stage ocular complications ( P = 0.02). Conclusions HZO patients present with relatively late‐stage ocular complications, and blindness among these patients is common. The delayed presentation to the ophthalmology outpatient department of hospitals in our rural setting is of concern, and efforts to improve ocular outcomes of HZO are urgently needed.