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Is there any benefit from oral vs topical steroids in herpes zoster opthalmicus?

Would the management change if there were complications with optic neuritis?
2 Answers
Mednet Member
Mednet MemberInvited Expert
Neurology · The University of Oklahoma College of Medicine
Answered on

The role of steroids in uncomplicated herpes zoster is limited, but weak evidence suggests they may provide some symptomatic relief. However, oral and topical steroids may have a role in complicated zoster, including cases with ocular involvement/HZO, when used with antiviral therapy, especially if ...

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Mednet Member
Mednet Member
Ophthalmology · University of Arkansas for Medical Sciences, Fayetteville Campus
Answered on

Agree with above, though I only use even topical steroids if ocular involvement. I have in recent years empirically found Zoster keratitis responds much better to high dose prolonged Acyclovir (a month 800 5Xdaily and then 600 mg TID for a year +) gradually calming down inflammatory keratitis cases ...

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