What are the causes of red eye following herpes zoster (shingles)?

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Differential Diagnosis for Red Eye Post Zoster

  • Single Most Likely Diagnosis
    • Herpes Zoster Keratitis: This is a common complication of herpes zoster ophthalmicus, where the virus affects the cornea, leading to inflammation and redness of the eye.
  • Other Likely Diagnoses
    • Herpes Zoster Iritis: Inflammation of the iris caused by the herpes zoster virus, which can lead to redness, pain, and sensitivity to light.
    • Herpes Zoster Conjunctivitis: Infection of the conjunctiva by the herpes zoster virus, resulting in redness, discharge, and irritation of the eye.
    • Postherpetic Neuralgia: While not directly causing red eye, this condition can lead to discomfort and pain in the eye, which may be mistaken for redness or other ocular symptoms.
  • Do Not Miss Diagnoses
    • Acute Angle-Closure Glaucoma: A medical emergency that can be triggered by herpes zoster infection, characterized by severe eye pain, redness, and vision loss.
    • Scleritis: Inflammation of the sclera, which can be caused by herpes zoster and leads to severe eye pain, redness, and tenderness.
    • Endophthalmitis: A rare but potentially devastating infection of the inner eye that can occur after herpes zoster, requiring prompt treatment to preserve vision.
  • Rare Diagnoses
    • Malignant Glaucoma: A rare condition associated with inflammation and increased intraocular pressure, which can occur after herpes zoster infection.
    • Phthisis Bulbi: A rare, end-stage condition where the eye becomes shrunken and non-functional due to chronic inflammation, potentially caused by untreated or severe herpes zoster infection.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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