Zoster sine herpete with bilateral ocular involvement

Am J Ophthalmol. 2000 Jun;129(6):809-10. doi: 10.1016/s0002-9394(00)00404-9.


Purpose: To report a case of zoster sine herpete with bilateral ocular involvement.

Method: Case report.

Results: A 65-year-old man showed bilateral iridocyclitis with sectoral iris atrophy and elevated intraocular pressure unresponsive to steroid treatment. No cutaneous eruption was manifest on the forehead. A target region of varicella-zoster virus DNA sequence was amplified from the aqueous sample from the left eye by polymerase chain reaction. Bilateral iridocyclitis resolved promptly after initiation of systemic and topical acyclovir treatment. Secondary glaucoma was well controlled by bilateral trabeculectomy.

Conclusions: Zoster sine herpete should be considered and polymerase chain reaction performed on an aqueous sample to detect varicella-zoster virus DNA for rapid diagnosis whenever anterior uveitis accompanies the characteristic iris atrophy, even in the case of bilateral involvement.

Publication types

  • Case Reports

MeSH terms

  • Acyclovir / therapeutic use
  • Aged
  • Antiviral Agents / therapeutic use
  • Atrophy / virology
  • DNA Primers / chemistry
  • DNA, Viral / analysis
  • Herpes Zoster Ophthalmicus / diagnosis
  • Herpes Zoster Ophthalmicus / drug therapy
  • Herpes Zoster Ophthalmicus / virology*
  • Herpesvirus 3, Human / genetics
  • Herpesvirus 3, Human / isolation & purification
  • Humans
  • Intraocular Pressure
  • Iridocyclitis / diagnosis
  • Iridocyclitis / drug therapy
  • Iridocyclitis / virology*
  • Iris / pathology
  • Male
  • Ocular Hypertension / diagnosis
  • Ocular Hypertension / surgery
  • Ocular Hypertension / virology
  • Polymerase Chain Reaction
  • Trabeculectomy
  • Visual Acuity


  • Antiviral Agents
  • DNA Primers
  • DNA, Viral
  • Acyclovir