The Progression of the Ocular Abnormalities of Herpes Zoster: Histopathologic Observations of Nine Cases

The ocular pathologic findings from nine patients who suffered from herpes zoster ophthalmicus are described. Autopsy material from four patients who died within weeks of the illness and ocular specimens from five patients who required surgery for complications of the disease months to years later demonstrated how the ocular abnormalities caused by zoster may progress in severity with time. The changes ranged from superficial keratitis and mild uveitis to severe granulomatous inflammation of the ciliary body, choroid, and optic nerve within the first several weeks of the disease. In some instances damage secondary to vasculitis predominated, and in others inflammation directly involved ocular tissue. In some chronically affected eyes, granulomatous reaction to Descemet's membrane persisted for years, whereas in others the inflammatory reaction apparently resolved, allowing successful penetrating keratoplasty to be performed in one case.