Review for Disease of the Year: Varicella Zoster Virus-Induced Anterior Uveitis

Ocul Immunol Inflamm. 2018;26(2):171-177. doi: 10.1080/09273948.2017.1383447. Epub 2017 Oct 12.


Varicella zoster virus (VZV)-induced anterior uveitis (AU) may complicate the course of primary varicella infection typically seen in children. In adults, especially with advanced age, VZV AU is more commonly associated with herpes zoster ophthalmicus (HZO) with or without skin rash affecting the distribution of the ophthalmic nerve due to reactivation of the latent VZV in the trigeminal ganglion. While it is typically a mild self-limiting AU in primary infection, HZO AU is often accompanied by keratitis, may have a chronic recurrent course, and lead to sectoral iris atrophy, pupillary distortion, and ocular hypertension. Diagnosis is often clinical and proven by analysis of aqueous humor for viral genome or antiviral antibodies. Systemic antiviral agents and topical steroids are the mainstay of treatment. Visual prognosis is favorable with timely diagnosis and appropriate treatment.

Keywords: Antiviral treatment; herpes zoster ophthalmicus; primary varicella infection; varicella zoster virus; viral anterior uveitis; visual prognosis.

Publication types

  • Review

MeSH terms

  • Antiviral Agents / therapeutic use
  • Aqueous Humor / virology
  • Eye Infections, Viral / diagnosis
  • Eye Infections, Viral / drug therapy
  • Eye Infections, Viral / virology*
  • Genome, Viral / genetics
  • Glucocorticoids / therapeutic use
  • Herpes Zoster Ophthalmicus / diagnosis
  • Herpes Zoster Ophthalmicus / drug therapy
  • Herpes Zoster Ophthalmicus / virology*
  • Herpesvirus 3, Human / genetics
  • Herpesvirus 3, Human / isolation & purification*
  • Humans
  • Uveitis, Anterior / diagnosis
  • Uveitis, Anterior / drug therapy
  • Uveitis, Anterior / virology*


  • Antiviral Agents
  • Glucocorticoids