Patients with herpes zoster ophthalmicus are treated with oral acyclovir (800 mg, five times daily) for seven to 10 days. Studies report alleviation of pain with oral acyclovir during the initial stages of the disease, especially if the drug is taken within the first three days of symptoms, and it may have a favorable effect on postherpetic neuralgia. 21 – 23 [Reference 22—Evidence level A, randomized controlled tiral (RCT). Reference 23—Evidence level A, RCT] Additionally, acyclovir administered within 72 hours of onset has been found to speed resolution of skin lesions, reduce viral shedding, and decrease the incidence of dendritic and stromal keratitis as well as anterior uveitis. 24 , 25
This occurs when herpes zoster affects the first (ophthalmic) branch of the trigeminal nerve. The blistering rash associated with shingles may be preceded by numbness, pain or tingling around the eye. The eye itself is affected in approximately 50% of cases of ophthalmic shingles.