What treatment strategies do you use to reduce the risk of post-herpetic neuralgia after herpes zoster ophthalmicus?

For prevention, our best tool is the VZV vaccine (Shingrix). I recommend that all patients over age 50 consider receiving it. However, if an individual develops VZO and has persistent pain, I begin with antiviral therapy to assess whether subclinical viral activation is contributing to the pain (dur...

Absolutely the best treatment is prevention, but alas in the current regime in DC we have a group that denies facts. If a patient gets HZ, I start with oral antivirals. There is good data that starting Gabapentin as soon as the diagnosis is made prevents post herpetic neuralgia (PHN). PHN is more co...

Prolonged use of antivirals.