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How to treat Herpes Zoster Ophthalmicus on the left eye ?

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General & Family Physician
Practicing since : 1998
Answered : 84 Questions
Dear Doctor,
I am 70 year old male. I got Herpes Zoster Ophthalmicus on the left eye since 10th of march. I have already finished antiviral (Acyclovir 800mg - 5 times a day for 10 days, also 2talets a day for 8 days and 3 tablets for 14 days) course and also taking suitable eye drops and ointments for my eye infection. Till now I have taken more than 100 Tablets of Acyclovir. What is standard dosage of Acyclovir? Have I taken over dosage?

Now I am better and almost recovering. As per advise of my Neurologist I am taking Antidepressant and Epilepsy tablets to manage my pain and my pain has reduced.

My left eye was better but since last week again its become red and lids are very sensitive and they are burning. My eye doctor says its due to Blepheritis and he has prescribed me Ciprofoxacin tablets and ointments and also suggested me to restart Acyclovir 800 mg 3 tablets per day for 4 weeks. Also what is dosage of Acyclovir as I have already taken more than 100 tablets? Also my problem is that I am unable to find a doctor who knows overall treatment for the Herpes. Can it recur? How can I prevent this? Any vaccines are available? Will the vaccines help me to get rid of herpes ?

Anil Tayade
Posted Mon, 7 May 2012 in Vision and Eye Disorders
Answered by Dr. Sheetal 3 hours later

Thanks for posting your query.

The usual recommended dose of acyclovir for the treatment of herpes zoster is 800 mg 5 times daily for 7 to 10 days. This regimen works best if treatment is started within 72 hours of onset of symptoms. It is also useful when started later but less so. Some patients do require extended courses of the drug for months, particularly the elderly patients. If you are taking acyclovir as recommended by your doctor, do not worry about overdosage. Acyclovir is the recommended drug and duration depends on the response. Some patients may also need intravenous acyclovir.

Unfortunately, herpes zoster does tend to recur. Late complications can occur over weeks or months. The blepharitis that you are experiencing is also a complication of the initial HZ infection possibly worsened by a bacterial superinfection. The treatment that you are receiving is optimum. Antidepressants and/ or antiepileptics for pain relief are also required.

There is a vaccine known as Zostavax which is used to prevent herpes zoster in persons >50 years of age. The vaccine reduces the chances of getting herpes zoster but it cannot completely eliminate the risk. Since you have already been affected, the vaccine may not help you much. You can talk to your doctor about it though.

Though you seem to be receiving adequate treatment, if you are not fully satisfied with your doctor's advice you can consider taking a specialists' opinion at our Website. Here is where you can find some expert eye specialists: WWW.WWWW.WW
Hope I have answered your query. I will be available if you have any further queries.
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