A study of clinical profile and ophthalmological manifestations of herpes zoster ophthalmicus with HIV seropositivity in Northern Karnataka

Objective To evaluate the clinical profile and ophthalmological manifestations of herpes zoster ophthalmicus and to identify HIV seropositivity in them. Methods The study was a hospital based observational study. After obtaining an informed oral consent, all subjects in this study were submitted to a full history taking, general medical and dermatological examination, ophthalmological history and examination with slit lamp and dilated fundus examination. Results A total number of 25 cases were studied. Majority of the patients (25%) were in the age group of 60-69 years. Mean age was 46.8 years. Male to female ratio was 2.1:1. Left side of the face was involved in 14 (56%) patients and right side in 11 (44%) patients. Majority of the patients (60%) presented within 5 days of the onset of the disease. Out of 25 patients, 1 patient was known HIV seropositive and 3 patients were newly detected as HIV seropositive. Fifteen cases (60.0%) presented with best corrected visual acuity (BCVA) of 20/20, N6. Lid edema ranging from mild to severe and conjunctival hyperemia was noted in 19 cases (76.0%) at presentation. Corneal involvement in the form of decreased or absent sensation was noted in 13 cases (52%), 3 cases had dendritic ulcer (1.2%), 3 patients had stromal keratitis (1.2%) and 1 case had punctuate keratopathy (0.4%). Conclusion Our study outlines the varied clinical profile of herpes zoster ophthalmicus in north Karnataka. The higher incidence of lid edema is due to the application of mud over the lesions. Though low HIV seroprevalence is recorded in HZO patients, it is marginally high in young population. HZO may be taken as an indicator for HIV screening in younger population.