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| ARTICLES |
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| Year : 1978 | Volume
: 26
| Issue : 4 | Page : 50-51 |
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Herpes zoster in children
S Gupta, SS Soodan, SP Pahda, FS Bali
Department of Ophthalmology, Govt. Medical College, Jammu, India
Correspondence Address:
S Gupta
Department of Ophthalmology, Govt. Medical College, Jammu
India
 Source of Support: None, Conflict of Interest: None  | Check |
PMID: 220193 
How to cite this article:
Gupta S, Soodan S S, Pahda S P, Bali F S. Herpes zoster in children. Indian J Ophthalmol 1978;26:50-1 |
Varicella and Zoster are caused by the same virus, V-Z virus. While varicella is mild highly infectious febrile disease occuring particularly in children, Zoster commonly affects the adults and older people. The dorsal root ganglia of the cord or the extramedullary ganglia of the cranial nerves, both sensory and motor are infected by virus and the lesions first vesicular and then nocrotic appear in the distribution of the nerve.
The ophthalmic division of the trigeminal is usually affected when the gasseriam ganglion is involved. The second or the maxillary division is rarely involved and involvement of both is only occasional' however involvement of all the three has also been reported[2].
We here report two cases of herpeszoster ophthalmicus in young children aged 7 and 6 years. One of the patients had the involvement of both Ist and Ilnd divisions of trigeminal nerve.
| Case report | |  |
Case I: Patient S.D. [Figure - 1] Seven years old female child was seen in eye out patient deptt. of S.M.G.S. Hospital on 12.11.1975 with complaints of pain and vesicular eruptions on left half of face, eye lids, fore-head and scalp for the last six days.
Examination
Right Eye normal.
Left Eye: Visual acvity was 6/60. Both lids were swollen with vesicles over the left half forehead, both the eye lids, left cheek, left side and tip of nose, and left half of upper lip. Skin adjacant to eruptions was oedematous. Bulbar conjunctiva was congested and chemosed. Cornea showed superficial punctate staining and corneal sensitivity was absent, Anterior chamber and pupil were normal. Fundus was normal. The buccal mucosa on left side also showed vesicular erruptions.
Treatment
The child was kept on tetracycline suspension in left eye 3-4 times a day and calamine lotion was applied locally on the skin In addition, analgesics and neurotropic vitamins (Bl, B6 and B12) were given orally. The vesicles cleared gradually after a fortnight, leaving pitted scars on the affected skin. The cornea also cleared without scarring. Vision returned to 6/6 JI.
Case II
Patient B; [Figure - 2] Six years old female child first seen on 16.10.75 with complaints of burning sensation on right side of the forehead and scalp. One day later the child could not open right eye and a few vesicular eruptions had appeared on the right side of the forehead.
On 19.10 75 the child had full clinical picture of the herpeszoster. The conjunctiva was chemosed and congested, cornea showed superficial punctate staining. The child did not cooperate to record visual acuity. There was no other abnormality in the right eye, the left eye was normal.
| Discussion | | |
Herpeszoster ophthalmicus is more common in adults while the varicella caused by morphologically similar virus is prevalent in children. However herpeszoster has been reported in younger age group by various authors, in an infant at birth[2] in an infant of 20 hours[1] child of one year[2] 2 years[2] 4½ years 5 years[1],[4] 7 years[1] 8 years.[1] Our cases were aged 7 years and 6 years. Lower incidence of herpeszoster in younger age groups may be due to some sort of immunity conferred by varicella infection which is common in children.
Herpeszoster in ophthalmology is important when gasserian ganglion is involved. Ophthalmic division of trigeminal is usually involved. The involvement of maxillary division as such and of both the first and second divisions is rare. One of our patient (Case I) had involvement of both the Ophthalmic and maxillary divisions.
| Summary | | |
Two cases of Herpeszoster ophthalmicus in young children are reported. In one of the patients there was associated involvement of maxillary division of the trigeminal nerve which in itself is a rare phenomenon[6].
| References | | |
| 1. | Ahmad. M, 1969 Orient. Arch. Ophthal., 7, 38  |
| 2. | Duke Elder, 1965, Systems of Ophthalmology. 8., 1, 337. Henry Kimpton London. |
| 3. | Lal K, 1970, Orient. Arch. Ophthal., 8, 43 |
| 4. | Malik S.R.K, Sood G.C, Gupta S.B. and Gupta D.K., 1964, Orient, Arch. Ophthal., 2, 92. |
| 5. | Nirankari M.S. and Sangha S.S., 1967, Orient. Arch. Ophthal., 5, 287. |
| 6. | Saxena G.S., 1964, J. All Ind. Ophthal. Soc., 12,132. |
[Figure - 1], [Figure - 2]
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