acyclovir and Hyphema

To report a case of herpes zoster sine herpete presenting with hyphema.. A 69-year-old man was referred for traumatic hyphema and corneal edema in his left eye after a sandblast exposure three weeks previously. Slit-lamp examination demonstrated hyphema, anterior chamber inflammation, mid-dilated pupil, impaired corneal sensation, and high intraocular pressure, without any facial skin lesions. Iris fluorescein angiography revealed tortuosity and extensive occlusion of iris vessels. The patient was treated with oral acyclovir and intensive topical steroids with a presumed diagnosis of severe herpes zoster uveitis.. Clinical findings improved dramatically within several days. Typical sectorial iris atrophy with pupillary sphincter dysfunction and complete loss of corneal sensation developed after the resolution of intraocular inflammation.. Herpes zoster should be considered in patients with uveitis and hyphema even in the absence of typical skin rash.

Topics: Acyclovir; Administration, Oral; Aged; Antiviral Agents; Cornea; Corneal Edema; Diagnosis, Differential; Fluorescein Angiography; Fundus Oculi; Herpes Zoster Ophthalmicus; Humans; Hyphema; Iris; Male; Severity of Illness Index

We treated two patients with herpes zoster ophthalmicus in whom hyphema and hemorrhagic glaucoma occurred. Case 1 complained of facial skin eruption, and was given intravenous acyclovir for 7 days. Hyphema and high intraocular pressure occurred in the left eye 10 days after the onset of the skin eruption. Case 2 had severe pain and blisters on her face, and was given intravenous acyclovir for 7 days. An intracameral hemorrhage and glaucoma developed in the right eye 15 days after the onset of the skin lesion. Intravenous acyclovir may be necessary for longer than 7-day periods if the iridocyclitis remains.

Topics: Acyclovir; Aged; Aged, 80 and over; Dermatitis; Eye Diseases; Face; Glaucoma; Hemorrhage; Herpes Zoster Ophthalmicus; Humans; Hyphema; Injections, Intravenous; Male