IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) e-ISSN: 2279-0853, p-ISSN: 2279-0861.Volume 19, Issue 6 Ser.12 (June. 2020), PP 15-21 www.iosrjournals.org DOI: 10.9790/0853-1906121521 www.iosrjournal.org 15 | Page Study of ocular manifestations and factors affecting visual outcome in Herpes Zoster Ophthalmicus Dr Gautam Kumar 1 , Dr Ranjeet Kumar 2 , Dr U P Bhadani 3 1. Department Of Ophthalmology, Patna Medical College Hospital, Patna. 2. Department of Ophthalmology, AIIMS, Patna. 3. Department Of Ophthalmology, Patna Medical College Hospital, Patna. Abstract- Background- Herpes zoster ophthalmicus results from reactivation of latent varicella zoster virus from trigeminal ganglia in previously exposed patients with low immunity. Aims of the study- Aims of the study is to find out common ocular manifestations of HZO and factors affecting visual outcome. Material and methods- This observational study was done on patients attending, Department of Ophthalmology, Patna medical college, Patna. The period of study was from October 2017 to December 2018. Total 35 patients were examined. Patients were followed on 7 th ,14 th , 30 day and 3 months after first visit. Results-28.57% cases were in age group 41-50 year. The males were 54.28% and female 45.71%. Conjunctivitis (77.1%) Corneal involvement (60%), Episcleritis (8.6%) Uveitis (57.1%) and Secondary glaucoma (5.7%) were common manifestations. Hutchinson signs was positive in 18 cases (n= 35 ). Corneal involvement and uveitis with Hutchinson signs were observed in 48.57%(p- value<0.001) and 45.71%,(p value <0.01) .Common predisposing factors were Diabetes mellitus(40%), HIV (22.85%), age->60 years 14.28%. 57.14% patients had no visual loss at 3 months follow up. 85.71% had vision 6/18 or better . Conclusions-With the increasing incidence of HIV and diabetes , Herpes Zoster Ophthalmicus was presenting with at younger age group. Corneal involvement and uveitis was strong predictor of visual loss in HZO. The involvement of frontal,nasociliary and lacrimal nerves and positive Hutchinson signs were associated with increased incidence of ocular complications like keratitis and uveitis. The inflammatory and immune mediated lesions of HZO responded well to treatment with good visual outcome. Key words- Herpes zoster ophthalmicus, Varicella zoster virus, Trigeminal ganglia, conjunctivitis, Corneal involvement, Uveitis, Hutchinson sign --------------------------------------------------------------------------------------------------------------------------------------- Date of Submission: 06-06-2020 Date of Acceptance: 22-06-2020 --------------------------------------------------------------------------------------------------------------------------------------- I. Introduction Herpes Zoster Ophthalmicus results from reactivation of latent varicella zoster virus from trigeminal ganglia in which ophthalmic division of trigeminal nerve is involved. Varicella zoster virus persists in the sensory ganglia of the cranial nerves and the spinal dorsal root ganglia after varicella resolves. 1 . Reactivation of varicella occurs when cellular immunity against virus falls. Patients of old age and patients who have neoplastic disease, organ transplant recipients or on immunosuppressive drugs are at risk of HZO. Other risk factors are HIV, diabetes, tuberculosis, irradiation and physical trauma. Incidence of herpes zoster ophthalmicus has increases 3.6% cases per 100000 person-years from 1994 to 2018 2 . II. Material and Methods This observational study was done on patients attending, Department of Ophthalmology, Patna medical college, Patna. The period of study was from October 2017 to December 2018. Total 35 patients were included in the study. Patients were followed up on 7 days, 14 days, 30 days and 3 months after first visit. Study duration- October 2017 to December 2018. Sample size-35 patients Subjects and selection methods-Those patients were enrolled who were attending OPD with specific clinical features which are suspicious for Herpes zoster ophthalmicus.Patients were from 11-80 year of age. Both male and female patients were included in this study Inclusion criteria- Patients presented with signs and symptoms of Herpes Zoster Ophthalmicus within 3 weeks of vesicle formation.